Organization
DDM INC
Active
Other names
MEDICAP PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DALE B MAUPIN RPH (PHARMACIST/OWNER)
(231) 943-0085
Entity
Organization
Contact information
Practice address
4025 CHUMS VILLAGE DR, STE A, TRAVERSE CITY, MI 49684-6992
(231) 943-0085
(231) 943-0095
Mailing address
4025 CHURNS VILLAGE DR., STE A., TRAVERSE CITY, MI 49684
(231) 943-0085
(231) 943-0095
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301007598
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2364064
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
2364064
—
MI
Enumeration date
08/20/2006
Last updated
12/29/2009
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