Organization
BUCKLEYS PHARMACY OF DETROIT LLC
Active
Other names
Buckley's Pharmacy #103
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY COLE (MANAGING MEMBER)
(313) 971-5030
Entity
Organization
Contact information
Practice address
14313 GREENFIELD RD, DETROIT, MI 48227-2107
(313) 272-0202
(313) 272-0924
Mailing address
14313 GREENFIELD RD, DETROIT, MI 48227-2107
(313) 272-0202
(313) 272-0924
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010055
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2377871
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/25/2013
Last updated
03/25/2013
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