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Organization

ANCHOR BAY PHARMACY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. DENNIS BLOOM HALSTEAD R.PH. (PRESIDENT)
(586) 725-3737
Entity
Organization

Contact information

Practice address
51006 WASHINGTON ST, NEW BALTIMORE, MI 48047-2157
(586) 725-3737
(586) 725-5610
Mailing address
51006 WASHINGTON ST, NEW BALTIMORE, MI 48047-2157
(586) 725-3737
(586) 725-5610

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301004295
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1687959
MI
01
5301004295
STATE ID
MI
Enumeration date
10/28/2005
Last updated
08/22/2020
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