12 Mile Road Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Berkley, MI
NPI 1275170441 · NPPES record last updated Mar 18, 2021
Key facts
- NPI
- 1275170441
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- 12 MILE ROAD PHARMACY LLC
- Practice address
- 3348 12 Mile Rd
Berkley, MI 48072-1344 - Phone
- (248) 677-3584
- NPI assigned
- Dec 5, 2019
- Organization subpart
- No
Authorized official
- Name
- Evan Johnson
- Title
- Owner
- Phone
- (248) 677-3584
National Provider Directory
Locations
3348 W 12 Mile Rd
Berkley, MI 48072
Phone (248) 542-6337
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
3348 12 Mile Rd
Berkley, MI 48072-1344
Mailing address
3348 12 Mile Rd
Berkley, MI 48072-1344
Phone (248) 677-3584
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | PHARMACY |
Other providers in Berkley, MI
All providers in Berkley, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.