Organization
WESTSIDE PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GREGORY S BOVEE RPH (PRESIDENT/TREASURER)
(517) 323-2382
Entity
Organization
Contact information
Practice address
632 N DIBBLE BVD, LANSING, MI 48917
(517) 323-2382
(517) 323-0459
Mailing address
632 N DIBBLE BVD, LANSING, MI 48917
(517) 323-2382
(517) 323-0459
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
5301005171
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2317849
NCPDP
—
Enumeration date
06/01/2005
Last updated
08/22/2020
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