Organization
THE BEAVERTON PHARMACY INC
Active
Other names
BEAVERTON PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT RIFFERT (PHARMACIST PRESIDENT)
(989) 435-7778
Entity
Organization
Contact information
Practice address
127 W BROWN ST, BEAVERTON, MI 48612-8119
(989) 435-7778
(989) 435-2581
Mailing address
PO BOX 575, BEAVERTON, MI 48612-0575
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301005882
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042247
PK
—
05
—
2933529
—
MI
Enumeration date
10/12/2006
Last updated
07/20/2020
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