Organization
BROAD STREET PHARMACY, INC
Active
Parent organization
BROAD STREET PHARMACY, LTC
Other names
BROAD STREET PHARMACY, LTC
Organization subpart
Yes
Provider details
NPI number
Legal business name
BROAD STREET PHARMACY, LTC
Authorized official
DR. TAMARA ELIZABETH MASON (OWNER)
(989) 845-9355
Entity
Organization
Contact information
Practice address
1115 W BROAD ST, CHESANING, MI 48616-1068
(989) 845-9355
(989) 845-9356
Mailing address
1115 W BROAD ST, CHESANING, MI 48616-1068
(989) 845-9355
(989) 845-9356
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
11/06/2025
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