Organization
OLIVET PHARMACY INC
Active
Other names
OLIVET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA KING RPH (PRESIDENT AND OWNER)
(269) 749-2301
Entity
Organization
Contact information
Practice address
102 WASHINGTON ST, OLIVET, MI 49076-9462
(269) 749-2301
(269) 749-2301
Mailing address
PO BOX 537, OLIVET, MI 49076-0537
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301000875
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1737040
—
MI
01
—
2318978
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/11/2006
Last updated
09/27/2011
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