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| Type | Company | [sources] | |||
|---|---|---|---|---|---|
| Name | Buckley's Pharmacy 103 | [sources] | |||
| Incorporation date | not available | [sources] | |||
| Jurisdiction | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| Description | License number: 5301010625 | [sources] | |||
| NPI | 1902148356 | [sources] | |||
| Registration number | not available | [sources] | |||
| Sector | Pharmacy | [sources] | |||
| Address | Warren, MI | [sources] | |||
| Last change | Last processed | First seen | |||
Providers who have been terminated for cause from Michigan's Medicaid program.
United States of America · MDHHS
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| Sanctions | |||||
|---|---|---|---|---|---|
| Country | Authority | Program | Start date | End date | |
| United States of America | Michigan Department of Health & Human Services | - | |||
| Linked from | ||||
|---|---|---|---|---|
| Subject | Role | Start date | End date | |
| Samir Anthony Berri Cole Debarred entity | - | - | - | |