# PAW PAW VILLAGE DRUG, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Paw Paw Village Drug-LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467282269
- **Authorized official:** DR. JEFFREY ROBERT STULL PHARM.D. (OWNER)
- **Authorized official phone:** (269) 657-6073

## Contact information

- **Practice address:** 322 E MICHIGAN AVE, PAW PAW, MI 49079-1408
- **Practice address phone:** (269) 657-6073
- **Practice address fax:** (269) 655-1643
- **Mailing address:** 322 E MICHIGAN AVE, PAW PAW, MI 49079-1408
- **Mailing address phone:** (269) 657-6073
- **Mailing address fax:** (269) 655-1643

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 08/06/2024
- **Last updated:** 08/06/2024