Organization
STATE STREET PHARMACY & WELLNESS CENTER INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM ZOVISHLACK (PRESIDENT)
(989) 672-3500
Entity
Organization
Contact information
Practice address
192 N STATE ST, CARO, MI 48723-1550
(989) 672-3500
(989) 672-3555
Mailing address
192 N STATE ST, CARO, MI 48723-1550
(989) 672-3500
(989) 672-3555
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301007028
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2360131
NCPDP NUMBER
MI
Enumeration date
08/29/2006
Last updated
03/08/2024
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