Organization
BEAVERTON FAMILY PHARMACY LLC
Active
Other names
Beaverton Family Pharmacy LTC
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN GROSS (OWNER)
(989) 339-9008
Entity
Organization
Contact information
Practice address
3210 W LANG RD, BEAVERTON, MI 48612-8102
(989) 339-9008
Mailing address
11271 HARRISON AVE, FARWELL, MI 48622-9439
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
10/30/2024
Last updated
10/30/2024
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