Basic Information
Provider Information
NPI: 1356066393
EntityType: 2
ReplacementNPI:  
OrganizationName: BATTLE CREEK PHARMACY INC
LastName:  
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Mailing Information
Address1: 5908 BRECKENRIDGE PARKWAY
Address2:  
City: TAMPA
State: FL
PostalCode: 33610
CountryCode: US
TelephoneNumber: 8133042221
FaxNumber:  
Practice Location
Address1: 16311 GRAND RIVER AVE
Address2:  
City: DETROIT
State: MI
PostalCode: 48227
CountryCode: US
TelephoneNumber: 3138381100
FaxNumber: 3138381103
Other Information
ProviderEnumerationDate: 10/11/2022
LastUpdateDate: 10/13/2022
NPIDeactivationReasonCode:  
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AuthorizedOfficialLastName: PATEL
AuthorizedOfficialFirstName: ALPESH
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AuthorizedOfficialTitleorPosition: OWNER
AuthorizedOfficialTelephone: 8133042221
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
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AuthorizedOfficialCredential:  
NPICertificationDate: 10/13/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
3336L0003X  Y SuppliersPharmacyLong Term Care Pharmacy

No ID Information.


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