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Organization
HUDSON PHARMACY INC
Active
Organization
HUDSON PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOANN MARIE SANBORN RPH (VP OPERATIONS)
(517) 448-3111
Entity
Organization
Contact information
Practice address
325 RAILROAD ST STE D, HUDSON, MI 49247-1062
(517) 448-3111
(517) 448-5892
Mailing address
1410 W GANSON ST, JACKSON, MI 49202-4063
(517) 789-8980
(517) 789-0115
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0352390001
MEDICARE SUPPLIER NUMBER
—
05
—
1174696926
—
MI
Enumeration date
09/13/2021
Last updated
09/13/2021
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