Organization
HACKLEY PHARMACY MUSKEGON HTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARTER BOSSE (DIRECTOR OF PHARMACY)
(231) 728-5974
Entity
Organization
Contact information
Practice address
2700 BAKER ST, ROBERT A WARREN BLDG, MUSKEGON HEIGHTS, MI 49444-2157
(231) 737-9510
(231) 739-0837
Mailing address
2700 BAKER ST, ROBERT A WARREN BLDG, MUSKEGON HEIGHTS, MI 49444-2157
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301006384
MI
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2355510
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
3222835
—
MI
Enumeration date
02/12/2007
Last updated
09/12/2007
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