Organization
IN HOME CARE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NORA BOITEN RN (COO)
(616) 846-2015
Entity
Organization
Contact information
Practice address
1309 SHELDON RD, GRAND HAVEN, MI 49417-2404
(616) 847-5504
Mailing address
1309 SHELDON RD, GRAND HAVEN, MI 49417-2404
(616) 847-5504
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
107396
CARE CHOICES
MI
01
—
2348488
NABP
MI
05
—
2734516
—
MI
05
—
2778388
—
MI
01
—
540G00327
BCBS-PROFESSIONAL
MI
01
—
P78204
BLUE CARE NETWORK
MI
Enumeration date
09/27/2005
Last updated
08/22/2020
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