Provider Demographics
NPI:1871190462
Name:BIDDLE PHARMACY LLC
Entity Type:Organization
Organization Name:BIDDLE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RENU
Authorized Official - Middle Name:
Authorized Official - Last Name:PATHAK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:443-783-5539
Mailing Address - Street 1:3125 GRAHAM DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5082
Mailing Address - Country:US
Mailing Address - Phone:443-783-5539
Mailing Address - Fax:
Practice Address - Street 1:3640 BIDDLE AVE STE A
Practice Address - Street 2:
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-6515
Practice Address - Country:US
Practice Address - Phone:734-284-5100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-06
Last Update Date:2020-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy