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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