<Unavail>

LBN: Kentwood Pharmacy
<Unavail> is an health care organization with primary practice located at 116 N Mill St , Saint Louis MI 48880-1521. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. Kentwood Pharmacy can be contacted via phone (989) 681-6633, or through Downer, Mark via phone (616) 827-9100.

Contact Information

Primary practice address
116 N Mill St Saint Louis MI 48880-1521
Phone: (989) 681-6633
Fax: (989) 681-6644
Website:
Map and Directions
Authorized official contact:
Name: Downer, Mark
Phone: (616) 827-9100

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Long Term Care Pharmacy 3336L0003X 5901008943 Michigan

Profile Details

NPI number 1760638019
LBN Legal business name Kentwood Pharmacy
DBA Doing business as <Unavail>
Authorized official Downer, Mark
Entity Organization
Organization subpart 1 No
Enumeration date Aug 18th, 2008
Last updated Jul 9th, 2010 - about 16 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 1760638019 NPPES
Other 2372263 NCPDP PROVIDER IDENTIFICATION NUMBER

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