Organization
PGPA LLC
Active
Other names
PGPA Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LYNNE ADRIANROBERTS (PARTNER)
(517) 381-7472
Entity
Organization
Contact information
Practice address
3544 MERIDIAN CROSSINGS, STE 120, OKEMOS, MI 48864-6025
(517) 381-7472
(517) 381-8724
Mailing address
3544 MERIDIAN CROSSINGS, STE 120, OKEMOS, MI 48864-6025
(517) 381-7472
(517) 381-8724
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301006602
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00668987
—
MI
01
—
2043986
PK
—
05
—
3368731
—
MI
Enumeration date
11/17/2006
Last updated
03/08/2019
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