Organization
OSCODA COMMUNITY PHARMACY
Active
Organization
OSCODA COMMUNITY PHARMACY
Active
Other names
OSCODA COMMUNITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
STEVE QUISENBERRY (OWNER)
(989) 739-0020
Entity
Organization
Contact information
Practice address
5737 N US 23, STE 8, OSCODA, MI 48750-8728
(989) 739-0020
(989) 739-0764
Mailing address
5737 N US 23, STE 8, OSCODA, MI 48750-8728
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301004689
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2342652
NCPDP PROVIDER IDENTIFICATION NUMBER
—
05
—
2342652
—
MI
Enumeration date
08/10/2006
Last updated
01/12/2009
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