Organization
CENTERVILLE VILLAGE PHARMACY
Active
Other names
CENTERVILLE VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES THOMPSON PHARMACIST (PHARMACIST)
(269) 467-6354
Entity
Organization
Contact information
Practice address
666 E MAIN ST, CENTREVILLE, MI 49032-9803
(269) 467-6354
(269) 467-8503
Mailing address
PO BOX 547, CENTREVILLE, MI 49032-0547
(269) 467-6354
(269) 467-8503
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007448
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2354861
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2354861
—
MI
Enumeration date
10/07/2006
Last updated
04/29/2010
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