Provider Demographics
NPI:1609923457
Name:CHOICE PHARMACY
Entity Type:Organization
Organization Name:CHOICE PHARMACY
Other - Org Name:VMR LLC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:VAL
Authorized Official - Middle Name:A
Authorized Official - Last Name:OGBENAYA
Authorized Official - Suffix:
Authorized Official - Credentials:BSC PHARMACY
Authorized Official - Phone:734-595-3051
Mailing Address - Street 1:968 N NEWBURGH RD
Mailing Address - Street 2:968 N. NEWBURGH
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-3286
Mailing Address - Country:US
Mailing Address - Phone:734-595-3051
Mailing Address - Fax:734-595-3527
Practice Address - Street 1:968 N NEWBURGH RD
Practice Address - Street 2:968 N. NEWBURGH
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-3286
Practice Address - Country:US
Practice Address - Phone:734-595-3051
Practice Address - Fax:734-595-3527
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301008154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty