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Organization
BLUE WATER PHARMACY LLC
Active
Organization
BLUE WATER PHARMACY LLC
Active
Other names
Blue Water Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
1524 10TH STREET, PORT HURON, MI 48060
(810) 982-3100
(810) 982-3106
Mailing address
1524 10TH STREET, PORT HURON, MI 48060
(813) 304-2221
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Enumeration date
04/07/2020
Last updated
08/25/2020
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