Organization
WILLARD FOODS INC
Active
Other names
PLYMOUTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE KRIETEMEYER RPH (PHARMACY MANAGER)
(419) 687-5332
Entity
Organization
Contact information
Practice address
262 SANDUSKY ST, PLYMOUTH, OH 44865-1151
(419) 687-5332
(419) 687-7685
Mailing address
262 SANDUSKY ST, PLYMOUTH, OH 44865-1151
(419) 687-5332
(419) 687-7685
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
021950600
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0503262
—
OH
01
—
3623813
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/08/2006
Last updated
12/18/2009
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