Organization
PRIMECARE PHARMACY LLC
Active
Other names
Primecare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL DABAJA (PRESIDENT)
(269) 553-5000
Entity
Organization
Contact information
Practice address
3630 GULL RD, KALAMAZOO, MI 49048-1272
(269) 492-3300
Mailing address
3630 GULL RD, KALAMAZOO, MI 49048-1272
(269) 492-3300
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
5301009165
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2373037
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/04/2009
Last updated
10/06/2009
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