Organization
VAN BUREN PHARMACY LLC
Active
Organization
VAN BUREN PHARMACY LLC
Active
Other names
Van Buren Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SAMEERAH CORTEZ RPH (P.I.C.)
(734) 325-6318
Entity
Organization
Contact information
Practice address
11650 BELLEVILLE RD, SUITE 103, BELLEVILLE, MI 48111-3380
(734) 325-6318
(734) 325-1007
Mailing address
11650 BELLEVILLE RD, SUITE 103, BELLEVILLE, MI 48111-3380
(734) 325-6318
(734) 325-1007
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301010196
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1982922779
—
MI
01
—
2125315
PK
—
Enumeration date
05/04/2010
Last updated
11/15/2013
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