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Organization
PLYMOUTH TOWNE CARE PHARMACY INC
Active
Organization
PLYMOUTH TOWNE CARE PHARMACY INC
Active
Other names
PEOPLES DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BURGESS (MANAGER)
(574) 936-3167
Entity
Organization
Contact information
Practice address
301 N MICHIGAN ST, PLYMOUTH, IN 46563-1735
(574) 936-3167
(574) 936-6155
Mailing address
301 N MICHIGAN ST, PLYMOUTH, IN 46563-1735
(574) 936-3167
(574) 936-6155
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
60006496A
IN
3336L0003X
Long Term Care Pharmacy
Primary
054020404
IL
3336L0003X
Long Term Care Pharmacy
1929-43
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100309590B
—
IN
01
—
2170772
PK
—
Enumeration date
07/18/2017
Last updated
07/19/2018
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