# PLYMOUTH TOWNE CARE PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PEOPLES DRUG STORE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770006173
- **Authorized official:** JESSICA BURGESS (MANAGER)
- **Authorized official phone:** (574) 936-3167

## Contact information

- **Practice address:** 301 N MICHIGAN ST, PLYMOUTH, IN 46563-1735
- **Practice address phone:** (574) 936-3167
- **Practice address fax:** (574) 936-6155
- **Mailing address:** 301 N MICHIGAN ST, PLYMOUTH, IN 46563-1735
- **Mailing address phone:** (574) 936-3167
- **Mailing address fax:** (574) 936-6155

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | 60006496A | IN | — |
| 3336L0003X | Long Term Care Pharmacy | 054020404 | IL | Yes |
| 3336L0003X | Long Term Care Pharmacy | 1929-43 | WI | — |

## Other

- **Enumeration date:** 07/18/2017
- **Last updated:** 07/19/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100309590B | — | IN |
| 01 | — | 2170772 | PK | — |