Provider Demographics
NPI:1033425129
Name:FOOD VALUE & PHARMACY CORP
Entity Type:Organization
Organization Name:FOOD VALUE & PHARMACY CORP
Other - Org Name:WACKERLY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:CHANDRESH
Authorized Official - Middle Name:
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-755-7890
Mailing Address - Street 1:957 W MIDLAND RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-9406
Mailing Address - Country:US
Mailing Address - Phone:989-662-7773
Mailing Address - Fax:989-662-7778
Practice Address - Street 1:957 W MIDLAND RD
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MI
Practice Address - Zip Code:48611-9406
Practice Address - Country:US
Practice Address - Phone:989-662-7773
Practice Address - Fax:989-662-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-26
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010094083336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy