Organization
PLYMOUTH TOWNE CARE PHARMACY INC
Active
Other names
PEOPLES DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA BURGESS (MANAGER)
(574) 936-3167
Entity
Organization
Contact information
Practice address
301 N MICHIGAN ST, PLYMOUTH, IN 46563-1735
(574) 936-3167
(574) 936-6155
Mailing address
301 N MICHIGAN ST, PLYMOUTH, IN 46563-1735
(574) 936-3167
(574) 936-6155
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
60006496A
IN
3336L0003X
Long Term Care Pharmacy
Primary
054020404
IL
3336L0003X
Long Term Care Pharmacy
1929-43
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100309590B
—
IN
01
—
2170772
PK
—
Enumeration date
07/18/2017
Last updated
07/19/2018
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