Organization
WAKEFIELD PHARMACY ENTERPRISES LTD
Active
Other names
WAKEFIELD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY ROCCO RPH (OWNER)
(906) 229-5966
Entity
Organization
Contact information
Practice address
408 SUNDAY LAKE ST, WAKEFIELD, MI 49968-1338
(906) 229-5966
(906) 229-5707
Mailing address
PO BOX 171, WAKEFIELD, MI 49968-0171
(906) 229-5966
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
5301008317
MI
333600000X
Pharmacy
5301008317
MI
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2327953
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
871923680
—
MI
Enumeration date
07/30/2006
Last updated
09/04/2013
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