Organization
MK STORES INC
Active
Other names
MK Stores, LT Pharmacare
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C RUSSELL (PHARMACIST IN CHARGE)
(906) 485-5592
Entity
Organization
Contact information
Practice address
380 US HIGHWAY 41 EAST, NEGAUNEE, MI 49866
(906) 475-4424
(906) 475-4616
Mailing address
380 US HIGHWAY 41 EAST, NEGAUNEE, MI 49866
(906) 475-4424
(906) 475-4616
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
5301006635
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2357386
NABP NUMBER
MI
Enumeration date
08/01/2006
Last updated
04/10/2024
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