Organization
PIONEER PHARMACY CONSULTING LLC
Active
Other names
Great Lakes Pharmacy of Midland
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ALLEN BS PHARMACY (OWNER)
(989) 615-7212
Entity
Organization
Contact information
Practice address
1120 EASTMAN AVE, MIDLAND, MI 48640-4215
(989) 835-7911
(989) 835-6975
Mailing address
1120 EASTMAN AVE, MIDLAND, MI 48640-4215
(989) 835-7911
(989) 835-6975
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009642
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1942580972
—
MI
01
—
2131633
PK
—
Enumeration date
08/22/2011
Last updated
04/26/2019
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