Organization
MANTON FAMILY PHARMACY INC
Active
Other names
Bosticks Drugstore
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MOFFIT (OWNER)
(231) 824-6465
Entity
Organization
Contact information
Practice address
117 W MAIN ST, MANTON, MI 49663
(231) 824-6465
(231) 824-6466
Mailing address
PO BOX 368, MANTON, MI 49663-0368
(231) 824-6465
(231) 824-6466
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
530100966
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2376158
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/19/2011
Last updated
01/30/2018
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