Organization
HACKLEY COMMUNITY CARE CENTER, INC
Active
Parent organization
HACKLEY COMMUNITY CARE CENTER
Other names
Community Care Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
HACKLEY COMMUNITY CARE CENTER
Authorized official
MRS. VALERIE BLONDIN (CHIEF FINANCE OFFICE)
(231) 733-6657
Entity
Organization
Contact information
Practice address
2700 BAKER ST, MUSKEGON, MI 49444-2157
(231) 737-9510
(231) 739-0837
Mailing address
2700 BAKER ST, MUSKEGON, MI 49444-2157
(231) 737-9510
(231) 739-0837
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301008736
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5301008736
LICENSE NUMBER
MI
Enumeration date
11/14/2007
Last updated
10/20/2015
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