Organization
WAYLAND VILLAGE DRUG INC
Active
Other names
WAYLAND VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHEAL SHEA B.S. PHARMACY (OWNER)
(269) 792-6223
Entity
Organization
Contact information
Practice address
300 RENO DR, WAYLAND, MI 49348-1277
(269) 792-6223
(269) 792-6349
Mailing address
300 RENO DR, WAYLAND, MI 49348-1277
(269) 792-6223
(269) 792-6349
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301004420
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1758774
—
MI
01
—
2039491
PK
—
Enumeration date
08/10/2006
Last updated
06/16/2016
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