Organization
M K STORES INC
Active
Parent organization
MK STORES INC
Other names
SNYDER DRUG #208
Organization subpart
Yes
Provider details
NPI number
Legal business name
MK STORES INC
Authorized official
MICHAEL C RUSSELL (HEAD OF PHARMACY)
(906) 485-5592
Entity
Organization
Contact information
Practice address
7293 M-123, NEWBERRY, MI 49868
(906) 293-8571
(906) 293-1692
Mailing address
7293 M-123, NEWBERRY, MI 49868
(906) 293-8571
(906) 293-1692
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301007412
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301007412
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2362820
NAB NUMBER
MI
Enumeration date
08/02/2006
Last updated
04/10/2024
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