Organization
BLUE WATER PHARMACY LLC
Active
Other names
Blue Water Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ALPESH PATEL (OWNER)
(813) 304-2221
Entity
Organization
Contact information
Practice address
1524 10TH STREET, PORT HURON, MI 48060
(810) 982-3100
(810) 982-3106
Mailing address
1524 10TH STREET, PORT HURON, MI 48060
(813) 304-2221
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
04/07/2020
Last updated
08/25/2020
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