Organization
LIPPERT ENTERPRISES INC
Active
Parent organization
LIPPERT ENTERPRISES INC.
Other names
Evans Drug Store
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIPPERT ENTERPRISES INC.
Authorized official
MR. JOHN A. ISERHOTH III R.PH. (PHARMACY MANAGER)
(989) 828-6057
Entity
Organization
Contact information
Practice address
257 W WRIGHT AVE, EVANS DRUG STORE, SHEPHERD, MI 48883
(989) 828-6057
(989) 828-6821
Mailing address
P.O. BOX 69, EVANS DRUG STORE, SHEPHERD, MI 48883
(989) 828-6057
(989) 828-6821
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5301008051
MI
3336C0003X
Community/Retail Pharmacy
Primary
5301008051
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2366739
—
MI
Enumeration date
06/16/2005
Last updated
08/04/2008
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