Organization
FARM FRESH PHARMACY LLC
Active
Organization
FARM FRESH PHARMACY LLC
Active
Other names
FARM FRESH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
HETALBEHAN JARIWALA (OWNER)
(248) 545-5850
Entity
Organization
Contact information
Practice address
13151 W 10 MILE RD STE 1, OAK PARK, MI 48237-4601
(248) 545-5850
(248) 545-5851
Mailing address
13151 W 10 MILE RD STE 1, OAK PARK, MI 48237-4601
(248) 545-5850
(248) 545-5851
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009656
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851674709
—
MI
01
—
2375877
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/27/2011
Last updated
06/04/2012
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