D J Jacobetti Home For Veterans

LBN: State Of Michigan
D J Jacobetti Home For Veterans is an health care organization with primary practice located at 425 Fisher St , Marquette MI 49855-4521. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Institutional Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Long Term Care Pharmacy is the primary health care specialty. State Of Michigan can be contacted via phone (906) 226-3576, or through Harvala, Bradley G via phone (906) 226-3576.

Contact Information

Primary practice address
425 Fisher St Marquette MI 49855-4521
Phone: (906) 226-3576
Fax: (906) 226-3507
Website:
Map and Directions
Authorized official contact:
Name: Harvala, Bradley G PHARMD
Phone: (906) 226-3576

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 5302027451 Michigan
Suppliers / Institutional Pharmacy 3336I0012X 5302027451 Michigan
Suppliers / Long Term Care Pharmacy 3336L0003X 5301005604 Michigan

Profile Details

NPI number 1952704843
LBN Legal business name State Of Michigan
DBA Doing business as D J Jacobetti Home For Veterans
Authorized official Harvala, Bradley G PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2014
Last updated Mar 22nd, 2017 - about 9 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 1952704843 NPPES
Michigan MEDICAID 002286

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