Organization
WESTLAKE DRUG, INC.
Active
Other names
Westlake Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DEREK QUINN PHARM.D. (PHARMACY MANAGER)
(269) 327-3049
Entity
Organization
Contact information
Practice address
8822 PORTAGE RD, PORTAGE, MI 49002-6416
(269) 327-3049
(269) 327-5817
Mailing address
8822 PORTAGE RD, PORTAGE, MI 49002-6416
(269) 327-3049
(269) 327-5817
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301001583
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2302533
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/22/2006
Last updated
05/08/2012
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