Organization
HILL'S PHARMACY OF VICKSBURG, INC.
Active
Parent organization
HILL'S PHARMACY OF VICKSBURG, INC.
Other names
Hill's Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
HILL'S PHARMACY OF VICKSBURG, INC.
Authorized official
KELLY SOEKARMOEN R.PH. (OWNER/PHARMACIST)
(269) 649-1476
Entity
Organization
Contact information
Practice address
110 S MAIN ST, VICKSBURG, MI 49097-1211
(269) 649-1476
(269) 649-4007
Mailing address
110 S MAIN ST, VICKSBURG, MI 49097-1211
(269) 649-1476
(269) 649-4007
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301005736
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C912930
BCBS MICHIGAN
MI
05
—
872508050
—
MI
Enumeration date
05/25/2006
Last updated
09/29/2016
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