Organization
CENTERLINE PHARMACY LLC
Active
Other names
Centerline Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RAHUL KOCHHAR (PHARMACY MANAGER)
(586) 427-5344
Entity
Organization
Contact information
Practice address
8033 E 10 MILE RD, STE 103, CENTER LINE, MI 48015-1427
(586) 427-5344
Mailing address
8033 E 10 MILE RD, STE 103, CENTER LINE, MI 48015-1427
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009113
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2372807
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
05/13/2009
Last updated
12/22/2010
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