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Organization

LEFAVE PHARMACY & HOME MEDICAL EQUIPMENT

Active
Other names
LEFAVE PHARMACY AND HOME MEDICAL EQUIPMENT
Organization subpart
No

Provider details

NPI number
Authorized official
DR. KRISTINE LYNN SPICER PHARM.D. (OWNER)
(989) 354-3189
Entity
Organization

Contact information

Practice address
1202 W CHISHOLM ST, ALPENA, MI 49707-1620
(989) 354-3189
(989) 354-3286
Mailing address
1202 W CHISHOLM ST, ALPENA, MI 49707-1620
(989) 354-3189
(989) 354-3286

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301006955
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0N75720
MEDICARE PTAN - ROOSTER BILLING
MI
01
0Z40286
TYPE 54 MICHIGAN BCBS
MI
05
4170063
MI
Enumeration date
10/27/2006
Last updated
07/21/2022
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