Organization
THUNDER BAY COMMUNITY HEALTH SERVICE, INC
Active
Other names
THUNDER BAY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LORI WINEMAN (PHARMACY DIRECTOR)
(989) 785-5535
Entity
Organization
Contact information
Practice address
11899 M 32, ATLANTA, MI 49709-9374
(989) 785-5535
(989) 785-5267
Mailing address
PO BOX 850, 11899 M32, ATLANTA, MI 49709-0850
(989) 785-5535
(989) 785-5267
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007563
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2363959
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2363959
—
MI
Enumeration date
10/13/2006
Last updated
04/06/2017
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