Organization
SELAD CORPORATION
Active
Other names
Aspire Deckerville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA MCCONNACHIE (CO-CEO)
(989) 635-4000
Entity
Organization
Contact information
Practice address
2046 BLACK RIVER ST STE 2, DECKERVILLE, MI 48427-9448
(810) 376-8070
(810) 376-8171
Mailing address
2046 BLACK RIVER ST, DECKERVILLE, MI 48427-9448
(810) 376-8070
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009445
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2125651
PK
—
05
—
2374318
—
MI
Enumeration date
06/29/2010
Last updated
02/03/2025
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