Organization
COUNTRY MARKET PHARMACIES LLC
Active
Organization
COUNTRY MARKET PHARMACIES LLC
Active
Other names
Country Market Pharmacy 66
Organization subpart
No
Provider details
NPI number
Authorized official
GUY KENNEDY (MANAGING MEMBER)
(517) 787-6081
Entity
Organization
Contact information
Practice address
11301 BROOKLYN RD, BROOKLYN, MI 49230-8485
(517) 592-2475
(517) 592-2558
Mailing address
1821 SPRING ARBOR RD., JACKSON, MI 49203
(517) 787-6081
(517) 787-0160
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007904
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1346344306
—
MI
01
—
2046767
PK
—
Enumeration date
09/12/2006
Last updated
12/11/2024
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