Organization
S. FOUNTAIN'S INC
Active
Other names
dba The Medicine Shoppe #1189
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN MARK FOUNTAIN R.PH. (OWNER/PRES)
(989) 362-7415
Entity
Organization
Contact information
Practice address
133 NEWMAN ST, EAST TAWAS, MI 48730
(989) 362-7415
(989) 362-0597
Mailing address
133 NEWMAN ST, EAST TAWAS, MI 48730
(989) 362-7415
(989) 362-0597
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2349517
NABP
MI
05
—
2803794
—
MI
05
—
2803829
—
MI
Enumeration date
03/01/2006
Last updated
03/07/2023
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