Organization
NORTHGATE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JON VOLK RPH (OWNER)
(989) 269-8061
Entity
Organization
Contact information
Practice address
721 N VAN DYKE RD, BAD AXE, MI 48413-9188
(989) 269-8061
(989) 269-2094
Mailing address
721 N VAN DYKE RD, BAD AXE, MI 48413-9188
(989) 269-8061
(989) 269-9189
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
5301007690
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
540C210260
BLUE CROSS BLUE SHIELD
MI
05
—
874741850
—
MI
Enumeration date
05/12/2006
Last updated
03/30/2009
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