Pontiac Trail Pharmacy INC
NPI #1902914377 in Walled Lake, Michigan
Provider Information
- NPI Number
- 1902914377
- Entity Type
- Organization
- Organization Name
- Pontiac Trail Pharmacy INC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Aug 27, 2006
- Last Updated
- Aug 1, 2017
Practice Location
- Address
- 620 N. PONTIAC TRAIL
- City
- Walled Lake
- State
- Michigan
- ZIP Code
- 48390
- Phone
- (248) 669-2776
Authorized Official
- Name
- MR. CARL ROBERT HENDRICKS, R.PH
- Title
- OWNER/R.PH.
- Phone
- (248) 669-2776
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Long Term Care Pharmacy — Long Term Care Pharmacy |
| Clinic/Center - Health Service — Health Service |
| Durable Medical Equipment & Medical Supplies |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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