Organization
WEST MICHIGAN PHARMACY LLC
Active
Organization
WEST MICHIGAN PHARMACY LLC
Active
Other names
West Michigan Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY GOOTE PHARMD (PHCY MGR,PIC,AO)
(231) 305-4095
Entity
Organization
Contact information
Practice address
20095 GILBERT RD, BIG RAPIDS, MI 49307-2365
(231) 305-4095
(231) 305-4094
Mailing address
20095 GILBERT RD, BIG RAPIDS, MI 49307-2365
(231) 305-4095
(231) 305-4094
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010715
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149514
PK
—
Enumeration date
12/30/2014
Last updated
03/29/2017
Update your record
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