Organization
PGPA, LLC
Active
Other names
Benton Harbor Community Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNE ADRIAN-ROBERTS (MANAGER)
(517) 381-7472
Entity
Organization
Contact information
Practice address
800 M 139, BENTON HARBOR, MI 49022-3881
(269) 849-8251
(269) 927-2515
Mailing address
3544 MERIDIAN CROSSINGS, SUITE 120, OKEMOS, MI 48864-6025
(517) 381-7472
(517) 381-8724
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010603
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149003
PK
—
Enumeration date
11/26/2014
Last updated
08/22/2019
About Stedi
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