Organization
BIG D CORP
Active
Other names
Friendly Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DYTRI (PRESIDENT)
(586) 598-4650
Entity
Organization
Contact information
Practice address
19460 GRAND RIVER AVE, DETROIT, MI 48223-1200
(313) 533-0560
(313) 533-0568
Mailing address
C/O CHRISTOPHER PENCAK PC, 27322 23 MILE RD. STE. 7, CHESTERFIELD, MI 48051
(586) 598-4650
(586) 598-4651
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009518
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2375207
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/28/2011
Last updated
08/29/2011
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