Provider Demographics
NPI:1457812117
Name:PHARMTEK LLC
Entity Type:Organization
Organization Name:PHARMTEK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:CHANEL
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:KUTEK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-327-4244
Mailing Address - Street 1:3307 ORCHARD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:KEEGO HARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48320-1308
Mailing Address - Country:US
Mailing Address - Phone:248-327-4244
Mailing Address - Fax:248-859-0564
Practice Address - Street 1:3307 ORCHARD LAKE RD
Practice Address - Street 2:
Practice Address - City:KEEGO HARBOR
Practice Address - State:MI
Practice Address - Zip Code:48320-1308
Practice Address - Country:US
Practice Address - Phone:248-327-4244
Practice Address - Fax:248-859-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-26
Last Update Date:2020-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy