Independent Community Phcy

LBN: Independent Community Pharmacy Inc
Independent Community Phcy is an health care organization with primary practice located at 8742 W Warren , Dearborn MI 48126. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Independent Community Pharmacy Inc can be contacted via phone (313) 931-2133, or through Koblin, Victor via phone (318) 931-2133.

Contact Information

Primary practice address
8742 W Warren Dearborn MI 48126
Fax: (313) 931-3509
Website:
Authorized official contact:
Name: Koblin, Victor RPH

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 5301003741 Michigan
Suppliers / Clinic Pharmacy 3336C0002X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1801991757
LBN Legal business name Independent Community Pharmacy Inc
DBA Doing business as Independent Community Phcy
Authorized official Koblin, Victor RPH
Entity Organization
Organization subpart 1 No
Enumeration date Sep 14th, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801991757 NPPES
Michigan MEDICAID 2541233
Michigan Other 2333007

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