Organization
SKIDWAY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA JEAN SPIES (MEMBER)
(989) 876-8899
Entity
Organization
Contact information
Practice address
1830 GREENWOOD RD, PRESCOTT, MI 48756-8627
(989) 296-1360
(989) 296-1362
Mailing address
PO BOX 4488, PRESCOTT, MI 48756-4488
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2388494
—
MI
Enumeration date
09/08/2020
Last updated
03/05/2025
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