Provider Demographics
NPI:1417133430
Name:ORCHARD VIEW PHARMACY LLC
Entity Type:Organization
Organization Name:ORCHARD VIEW PHARMACY LLC
Other - Org Name:ORCHARD VIEW PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:V
Authorized Official - Last Name:SAYWRAYNE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:313-510-3313
Mailing Address - Street 1:12150 30 MILE RD STE 104
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48095
Mailing Address - Country:US
Mailing Address - Phone:586-336-9552
Mailing Address - Fax:586-336-9583
Practice Address - Street 1:12150 30 MILE RD STE 104
Practice Address - Street 2:
Practice Address - City:WASHINGTON TWP
Practice Address - State:MI
Practice Address - Zip Code:48095
Practice Address - Country:US
Practice Address - Phone:586-336-9552
Practice Address - Fax:586-336-9583
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VAPSCC, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-22
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010087843336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2043576OtherPK