Organization
NEIGHBORHOOD PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMEKA BACON RPH (OWNER)
(734) 649-0762
Entity
Organization
Contact information
Practice address
6508 WOODWARD AVE, DETROIT, MI 48202-3240
(313) 870-9810
(313) 870-9812
Mailing address
6508 WOODWARD AVE, DETROIT, MI 48202-3240
(313) 870-9810
(313) 870-9812
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008463
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2368694
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
09/04/2006
Last updated
09/13/2013
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