Organization
KENCO INC
Active
Organization
KENCO INC
Active
Other names
COUNTRY MARKET PHARMACY #11
Organization subpart
No
Provider details
NPI number
Authorized official
GRANT BROWN PHARM.D. (DIR OF PHARMACY OPERATIONS)
(517) 789-8980
Entity
Organization
Contact information
Practice address
1535 W MAUMEE ST, ADRIAN, MI 49221-1805
(517) 265-9162
(517) 266-1455
Mailing address
1821 SPRING ARBOR RD, JACKSON, MI 49203-2703
(517) 787-6081
(517) 787-0160
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301007786
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2044382
PK
—
05
—
2359506
—
MI
Enumeration date
09/12/2006
Last updated
07/19/2018
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