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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