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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