Provider Demographics
NPI:1336289024
Name:PHARMALOGICS, INC.
Entity Type:Organization
Organization Name:PHARMALOGICS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EARL
Authorized Official - Middle Name:PHILIP
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS RPH
Authorized Official - Phone:248-552-0070
Mailing Address - Street 1:17515 W 9 MILE RD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4403
Mailing Address - Country:US
Mailing Address - Phone:248-552-0070
Mailing Address - Fax:
Practice Address - Street 1:17515 W 9 MILE RD
Practice Address - Street 2:SUITE 360
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4403
Practice Address - Country:US
Practice Address - Phone:248-552-0070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010059923336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2353263OtherNABP