# PATTIE DRUG OF BALDWIN INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Pattie Drug
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912017310
- **Authorized official:** MS. TENNIS PATTIE TRUCKS RPH (PHARMACIST VICE PRESIDENT)
- **Authorized official phone:** (231) 745-4697

## Contact information

- **Practice address:** 868 MICHIGAN AVE, BALDWIN, MI 49304-0310
- **Practice address phone:** (231) 745-4697
- **Practice address fax:** (231) 745-8640
- **Mailing address:** PO BOX 310, BALDWIN, MI 49304
- **Mailing address phone:** (231) 745-4697
- **Mailing address fax:** (231) 745-8640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 183500000X | Pharmacist | 5301004991 | MI | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 09/04/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 23444Z8 | NABP | MI |
| 05 | — | 23444Z8 | — | MI |