Mattawan Pharmacy

LBN: Mattawan Pharmacy
Mattawan Pharmacy is an health care organization with primary practice located at 52366 N Main St , Mattawan MI 49071-0069. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Mattawan Pharmacy can be contacted via phone (269) 668-4571, or through Nantais, Edward via phone (269) 668-4549.

Contact Information

Primary practice address
52366 N Main St Mattawan MI 49071-0069
Phone: (269) 668-4571
Fax: (269) 668-3439
Website:
Map and Directions
Authorized official contact:
Name: Nantais, Edward
Phone: (269) 668-4549

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 5301005559 Michigan
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1376655365
LBN Legal business name Mattawan Pharmacy
DBA Doing business as
Authorized official Nantais, Edward
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2006
Last updated Jul 24th, 2008 - about 18 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 1376655365 NPPES
Michigan MEDICAID 2348565
Michigan Other 2348565

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