Organization
CENTRAL PHARMACY-MATTAWAN LLC
Active
Other names
Medicine Tree Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMED A BEYDOUN (OWNER)
(269) 673-4700
Entity
Organization
Contact information
Practice address
56109 VILLAGE CENTER CIR, MATTAWAN, MI 49071-8368
(269) 668-6801
(269) 668-6802
Mailing address
56109 VILLAGE CENTER CIR, MATTAWAN, MI 49071-8368
(269) 668-6801
(269) 668-6802
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009144
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2121009
PK
—
05
—
2372972
—
MI
Enumeration date
07/16/2009
Last updated
03/28/2023
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