Organization
THERA SCRIPT PHARMACY BERKLEY PLLC
Active
Organization
THERA SCRIPT PHARMACY BERKLEY PLLC
Active
Other names
THERA SCRIPT PHARMACY BERKLEY PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAZUR RAHMAN (MEMBER/MANAGER)
(313) 505-2822
Entity
Organization
Contact information
Practice address
3348 12 MILE RD, BERKLEY, MI 48072-1344
(248) 542-6337
Mailing address
3348 W. 12 MILE ROAD, BERKLEY, MI 48072
(248) 542-6337
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009882
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2377085
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/27/2012
Last updated
08/27/2012
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