Provider Demographics
NPI:1205047123
Name:R&G PHARMACY
Entity type:Organization
Organization Name:R&G PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:REMY
Authorized Official - Middle Name:
Authorized Official - Last Name:ONIMOE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:734-484-7132
Mailing Address - Street 1:1039 EMERICK ST
Mailing Address - Street 2:1039 EMERICK STREET
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48198-6310
Mailing Address - Country:US
Mailing Address - Phone:734-485-7132
Mailing Address - Fax:734-485-7162
Practice Address - Street 1:1039 EMERICK ST
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48198-6310
Practice Address - Country:US
Practice Address - Phone:734-485-7132
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301008614183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty