Organization
MIKES FAMILY PHARMACY INC
Active
Other names
MIKES FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL COOK (OWNER)
(231) 740-6025
Entity
Organization
Contact information
Practice address
8718 WATER ST STE A, MONTAGUE, MI 49437-1204
(231) 894-8633
(231) 893-3530
Mailing address
8718 WATER ST, SUITE A, MONTAGUE, MI 49437-1204
(231) 894-8633
(231) 893-3530
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301009749
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1467740688
—
MI
01
—
2375752
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/21/2011
Last updated
10/25/2012
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