Organization
PH COPPER COUNTRY APOTHECARIES LLC
Active
Other names
Copper Country Apothecary
Organization subpart
No
Provider details
NPI number
Authorized official
EMILY ROCHE (DIRECTOR OF RETAIL PHARMACY)
(906) 483-1905
Entity
Organization
Contact information
Practice address
500 CAMPUS DR, HANCOCK, MI 49930-1452
(906) 483-1901
(906) 483-1909
Mailing address
500 CAMPUS DR, HANCOCK, MI 49930-1452
(906) 483-1901
(906) 483-1909
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
5301010245
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255384178
—
MI
01
—
2143629
PK
—
Enumeration date
05/19/2006
Last updated
07/19/2018
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