Organization
SA2 DRUGS
Active
Other names
YOUR TELE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMIT PATEL (MEMBER)
(313) 278-3000
Entity
Organization
Contact information
Practice address
3159 S TELEGRAPH RD, DEARBORN, MI 48124-3242
(313) 278-3000
(313) 278-4622
Mailing address
3159 S TELEGRAPH RD, DEARBORN, MI 48124-3242
(313) 278-3000
(313) 278-4622
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2366373
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2366373
—
MI
Enumeration date
06/11/2006
Last updated
09/15/2010
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