Organization
MESICK PHARMACY INC
Active
Organization
MESICK PHARMACY INC
Active
Other names
Mesick Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM CONRAD RUNYON RPH (OWNER)
(231) 775-5073
Entity
Organization
Contact information
Practice address
112 MESICK AVE, MESICK, MI 49668
(231) 885-1751
(231) 885-1998
Mailing address
PO BOX 8, 112 MESICK AVE, MESICK, MI 49668
(231) 885-1751
(231) 885-1998
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301003492
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301003492
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2328789
—
MI
Enumeration date
08/08/2006
Last updated
10/18/2016
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