Organization
HACKLEY PROFESSIONAL PHARMACY
Active
Other names
HACKLEY PHARMACY WHITEHALL
Organization subpart
No
Provider details
NPI number
Authorized official
CARLTON BOSSE (DIRECTOR OF PHARMACY)
(231) 728-5974
Entity
Organization
Contact information
Practice address
905 E COLBY ST, WHITEHALL, MI 49461-1262
(231) 728-5974
(231) 728-1604
Mailing address
905 E COLBY ST, WHITEHALL, MI 49461-1262
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1852218
MI
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2369153
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/06/2007
Last updated
04/30/2009
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