Organization
INDEPENDENT COMMUNITY PHARMACY INC
Active
Other names
INDEPENDENT COMMUNITY PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR KOBLIN RPH (PRESIDENT)
(318) 931-2133
Entity
Organization
Contact information
Practice address
8742 W WARREN, DEARBORN, MI 48126
(313) 931-2133
(313) 931-3509
Mailing address
8742 W WARREN, DEARBORN, MI 48126
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301003741
MI
3336C0002X
Clinic Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2333007
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2541233
—
MI
Enumeration date
09/14/2006
Last updated
09/11/2025
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