Organization
CENTRAL LAKE PHARMACY INC
Active
Other names
Central Lake Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DUANE LYLE CHAPPUIES RPH (PRESIDENT)
(231) 536-7657
Entity
Organization
Contact information
Practice address
2424 N MAIN STREET, CENTRAL LAKE, MI 49622-0425
(231) 544-2929
(231) 544-5408
Mailing address
PO BOX 425, CENTRAL LAKE, MI 49622-0425
(231) 544-2929
(231) 544-5408
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301005744
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301005744
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2350750
—
MI
Enumeration date
02/15/2007
Last updated
02/12/2016
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