Provider Demographics
NPI:1114570504
Name:ADVANCE CARE RX PHARMACY
Entity Type:Organization
Organization Name:ADVANCE CARE RX PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/RPH
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PIZZUTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-826-1713
Mailing Address - Street 1:12097 CONANT ST
Mailing Address - Street 2:
Mailing Address - City:HAMTRAMCK
Mailing Address - State:MI
Mailing Address - Zip Code:48212-2716
Mailing Address - Country:US
Mailing Address - Phone:313-826-1713
Mailing Address - Fax:313-826-1714
Practice Address - Street 1:12097 CONANT ST
Practice Address - Street 2:
Practice Address - City:HAMTRAMCK
Practice Address - State:MI
Practice Address - Zip Code:48212-2716
Practice Address - Country:US
Practice Address - Phone:313-826-1713
Practice Address - Fax:313-826-1714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-24
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy