Organization
RXRUSS INC
Active
Other names
Westside Medical Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RUSS BOBLET (PHARMACIST/OWNER)
(269) 420-2990
Entity
Organization
Contact information
Practice address
6565 W MAIN ST, KALAMAZOO, MI 49009-6114
(269) 375-1700
(269) 375-1117
Mailing address
6565 W MAIN ST, KALAMAZOO, MI 49009-6114
(269) 375-1700
(269) 375-1117
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009157
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2120577
PK
—
Enumeration date
08/30/2006
Last updated
12/29/2015
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