Provider Demographics
NPI:1548640766
Name:PILLTALK PHARMACY
Entity type:Organization
Organization Name:PILLTALK PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MONTY
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KAMPOSH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-559-8555
Mailing Address - Street 1:23077 GREENFIELD RD
Mailing Address - Street 2:220
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-3709
Mailing Address - Country:US
Mailing Address - Phone:248-559-8555
Mailing Address - Fax:248-559-8554
Practice Address - Street 1:23077 GREENFIELD RD
Practice Address - Street 2:220
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-3709
Practice Address - Country:US
Practice Address - Phone:248-559-8555
Practice Address - Fax:248-559-8554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-03
Last Update Date:2015-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301010675333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy