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Organization
BRONSON VILLAGE DRUG, INC.
Active
Organization
BRONSON VILLAGE DRUG, INC.
Active
Other names
Aurora Long Term Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ROBERT STULL PHARM.D. (PHARMACIST)
(269) 668-1449
Entity
Organization
Contact information
Practice address
25344 RED ARROW HWY, MATTAWAN, MI 49071-9742
(269) 668-1449
(888) 498-1343
Mailing address
25344 RED ARROW HWY, MATTAWAN, MI 49071-9742
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5315226820
STATE OF MICHIGAN PHARMACY LICENSE
MI
Enumeration date
05/24/2021
Last updated
03/07/2023
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