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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