Organization
MODEL DRUG STORE
Active
Organization
MODEL DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SHARON BETH FISHER RPH (OWNER)
(616) 392-4707
Entity
Organization
Contact information
Practice address
35 W 8TH ST, HOLLAND, MI 49423-3102
(616) 392-4707
(616) 392-2449
Mailing address
35 W 8TH ST, HOLLAND, MI 49423-3102
(616) 392-4707
(616) 392-2449
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301002043
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1697599
—
MI
01
—
2306303
NCPDP
—
Enumeration date
08/12/2006
Last updated
03/24/2009
Update your record
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