Provider Demographics
NPI:1952018418
Name:HURON MARKET PHARMACY LLC
Entity Type:Organization
Organization Name:HURON MARKET PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BIMAL
Authorized Official - Middle Name:C
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-410-8461
Mailing Address - Street 1:6126 QUARTZ LN
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-7822
Mailing Address - Country:US
Mailing Address - Phone:810-410-8461
Mailing Address - Fax:248-507-4465
Practice Address - Street 1:1116 W HURON ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-3734
Practice Address - Country:US
Practice Address - Phone:810-410-8461
Practice Address - Fax:248-507-4465
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-03
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy