Tom's Pharmacy LLC

NPI #1174612618 in Portland, Michigan

Provider Information

NPI Number: 1174612618
Entity Type: Organization
Organization Name: Tom's Pharmacy LLC
Primary Specialty: Pharmacy
Enumeration Date: Oct 12, 2006
Last Updated: Dec 14, 2018

Practice Location

Address: 1462 E GRAND RIVER AVE
City: Portland
State: Michigan
ZIP Code: 48875
Phone: (517) 647-4861

Authorized Official

Name: STEVE ANTAYA
Title: VICE PRESIDENT
Phone: (517) 647-4861

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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