| NPI | 1982712352 |
|---|---|
| Doing Business As | MEDIVERA COMPOUNDING PHARMACY |
| Entity Type | Organization |
| Authorized Contact | BRADLEY MCCLOSKEY Pharmacist In Charge 248-267-5002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: MI 5301007150) |
| Additional Taxonomies | 3336S0011X Pharmacy, Specialty Pharmacy |
| Enumeration Date | 2006-08-27 |
| Last Update Date | 2025-09-30 |