Organization
PIONEER FAMILY PHARMACY INC
Active
Other names
PIONEER FAMILY PHARMACY #104
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BRAIDWOOD RPH (PRESIDENT)
(989) 389-7277
Entity
Organization
Contact information
Practice address
412 N 5TH ST, ROSCOMMON, MI 48653-9329
(989) 275-5600
(989) 275-4707
Mailing address
PO BOX 547, ROSCOMMON, MI 48653-0547
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008443
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042339
PK
—
05
—
2368668
—
MI
Enumeration date
08/24/2006
Last updated
05/05/2016
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