Organization
MANISTIQUE PHARMACEUTICALS INC
Active
Organization
MANISTIQUE PHARMACEUTICALS INC
Active
Other names
Putvin Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK A ROHDE R PH (OWNER PHARMACIST)
(906) 341-5494
Entity
Organization
Contact information
Practice address
211 S CEDAR ST, MANISTIQUE, MI 49854-1425
(906) 341-5494
(906) 341-6752
Mailing address
211 S CEDAR ST, MANISTIQUE, MI 49854-1425
(906) 341-5494
(906) 341-6752
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301001039
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2318283
BLUE CROSS BLUE SHIELD MI
MI
05
—
2318283
—
MI
Enumeration date
02/07/2007
Last updated
11/30/2023
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