Patrick Richard Long, RPh
Pharmacist in Detroit, MI. Individual provider (NPI-1).
NPI number1104958024
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1104958024
- Entity type
- Individual (NPI-1)
- Name
- Patrick Richard Long
- Credential
- RPh
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 9, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | 5302411076 | MI | Yes |
Practice location
2799 W Grand BlvdDetroit, MI 48202-2608
Phone 313-916-1644 · Fax 313-916-1302
Mailing address
5740 W Allen RdFowlerville, MI 48836-9745
Phone 517-223-7630
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