Provider Demographics
NPI:1467960658
Name:FIRSTCARE PHARMACY INC
Entity Type:Organization
Organization Name:FIRSTCARE PHARMACY INC
Other - Org Name:FIRSTCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/AO
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHANLIKIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-812-8412
Mailing Address - Street 1:217 MIDDLEBELT RD
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48135-2726
Mailing Address - Country:US
Mailing Address - Phone:800-314-1955
Mailing Address - Fax:889-994-3638
Practice Address - Street 1:217 MIDDLEBELT RD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:MI
Practice Address - Zip Code:48135-2726
Practice Address - Country:US
Practice Address - Phone:313-327-0040
Practice Address - Fax:313-327-0041
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MI53010113183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175925OtherPK