Organization
MATTAWAN PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD NANTAIS (OWNER PHCST)
(269) 668-4549
Entity
Organization
Contact information
Practice address
52366 N MAIN ST, MATTAWAN, MI 49071-0069
(269) 668-4571
(269) 668-3439
Mailing address
PO BOX 69, 52366 N MAIN ST, MATTAWAN, MI 49071-0069
(269) 668-4571
(269) 668-3439
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301005559
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2348565
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2348565
—
MI
Enumeration date
08/31/2006
Last updated
07/24/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us