Organization
CENTRAL PHARMACY - POTTERVILLE LLC
Active
Other names
Potterville Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDDIE HOSSAM SAID (OFFICER)
(517) 645-9800
Entity
Organization
Contact information
Practice address
121 E LANSING RD, POTTERVILLE, MI 48876-9799
(517) 645-9800
(517) 645-0900
Mailing address
121 E LANSING RD, POTTERVILLE, MI 48876-9799
(517) 645-9800
(517) 645-0900
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1558692517
—
MI
01
—
2373532
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
01/14/2010
Last updated
08/23/2023
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