Organization
FONGUH ENTERPRISES INC
Active
Other names
Ogemaw Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JUDE FONGUH (OWNER, AO)
(513) 602-2289
Entity
Organization
Contact information
Practice address
700 COLUMBUS AVE, WEST BRANCH, MI 48661-8705
(989) 343-5300
(989) 343-5301
Mailing address
PO BOX 281, WEST BRANCH, MI 48661-0281
(989) 343-5300
(989) 343-5301
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301011105
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2167593
PK
—
Enumeration date
12/22/2016
Last updated
04/26/2017
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