Organization
PH COPPER COUNTRY APOTHECARIES LLC
Active
Other names
Apothecary - Home Medical Equipment
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLOTTE LAWRENCE (SECRETARY)
(615) 920-7000
Entity
Organization
Contact information
Practice address
894 CAMPUS DR, SUITE A, HANCOCK, MI 49930-1644
(906) 483-1290
(906) 483-1291
Mailing address
894 CAMPUS DR STE A, HANCOCK, MI 49930-1644
(906) 483-1290
(906) 483-1291
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1235315979
—
MI
01
—
540C110440
BLUE CROSS
MI
Enumeration date
01/11/2008
Last updated
04/30/2024
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