Organization
BORDEN S FAMILY PHARMACY LLC
Active
Other names
OUR FAMILY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE V BROTHERTON PHARM. D. (OWNER/ PHARMACIST-IN-CHARGE)
(810) 547-1278
Entity
Organization
Contact information
Practice address
415 W VIENNA ST, CLIO, MI 48420
(810) 547-1278
(810) 547-1542
Mailing address
415 W VIENNA ST, CLIO, MI 48420-1307
(810) 547-1278
(810) 547-1542
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010744
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619306875
—
MI
01
—
2142935
PK
—
Enumeration date
11/07/2013
Last updated
05/27/2021
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