Organization
MANISTIQUE PHARMACEUTICALS INC.
Active
Other names
Putvin Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A ROHDE R.PH (PHARMACIST/OWNER)
(906) 341-5494
Entity
Organization
Contact information
Practice address
211 S CEDAR ST, MANISTIQUE, MI 49854-1425
(906) 341-5494
(906) 341-6752
Mailing address
211 S CEDAR ST, MANISTIQUE, MI 49854-1425
(906) 341-5494
(906) 341-6752
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5301001039
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2542606
—
MI
01
—
540G70250
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/25/2006
Last updated
08/29/2023
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