Great American Associates LLC
Pharmacy, Community/Retail Pharmacy in Southfield, MI. Organization (NPI-2).
NPI number1487907960
StatusActive
Last updated in NPPESNov 29, 2016
Details
- NPI
- 1487907960
- Entity type
- Organization (NPI-2)
- Legal business name
- Great American Associates LLC
- Organization subpart
- No
- Enumeration date
- Oct 20, 2012
- Last updated
- Nov 29, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 5301009932 | MI | Yes |
| 3336L0003X | Pharmacy, Long Term Care Pharmacy | 5301009932 | MI | |
| 3336S0011X | Pharmacy, Specialty Pharmacy | 5301009932 | MI |
Other names
- Grant Pharmacy (Doing Business As)
Practice location
29355 Northwestern HwySte 220
Southfield, MI 48034-1053
Phone 248-799-3900 · Fax 248-799-3992
Mailing address
29355 Northwestern Hwy Ste 220Southfield, MI 48034-1051
Phone 248-799-3900
Authorized official
Tony John Kokkatt
President
2487993900
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