Organization
CG INC
Active
Other names
Airport Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
JYOTSNABEN PATEL (PRESIDENT)
(248) 886-8175
Entity
Organization
Contact information
Practice address
2550 S TELEGRAPH RD STE 107A, BLOOMFIELD HILLS, MI 48302-0951
(248) 886-8175
(248) 886-8171
Mailing address
PO BOX 85990, WESTLAND, MI 48185-6090
(248) 886-8175
(248) 886-8171
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009192
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2373253
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/16/2009
Last updated
07/22/2011
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