Organization
PREFERRED SPECIALTY PHARMACY AND HOME INFUSION
Active
Other names
PREFERRED SPECIALTY PHARMACY AND HOME INFUSION
Organization subpart
No
Provider details
NPI number
Authorized official
JASON DIXON (PRES)
(313) 864-9000
Entity
Organization
Contact information
Practice address
16633 LIVERNOIS AVE, STE 3, DETROIT, MI 48221-3098
(313) 864-9000
(313) 864-9005
Mailing address
16633 LIVERNOIS AVE, STE 3, DETROIT, MI 48221-3098
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
1188219
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2371209
OTHER ID NUMBER
—
Enumeration date
05/21/2008
Last updated
11/05/2008
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