Organization
HACKLEY PROFESSIONAL PHARMACY
Active
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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