Organization
THE APOTHECARY SHOPPE PHARMACIES, LLC
Active
Other names
Eastland Apothecary Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY PACH (CHIEF FINANCIAL OFFICER)
(800) 313-3677
Entity
Organization
Contact information
Practice address
1217 E FRONT ST, TRAVERSE CITY, MI 49686-2928
(231) 947-9825
(231) 947-3102
Mailing address
PO BOX 1727, MIDLAND, MI 48641-1727
(800) 313-3677
(989) 631-2820
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008204
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2334857
NCPDP
MI
05
—
502334857
—
MI
01
—
540B812050
BCBS DME
MI
05
—
875438844
—
MI
Enumeration date
10/17/2006
Last updated
03/17/2009
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