Organization
HACKLEY PROFESSIONAL PHARMACY, INC
Active
Parent organization
HACKLEY PROFESSIONAL PHARMACY, INC
Other names
Trinity Health Pharmacy - Lakes Village, MERCY HEALTH PHARMACY- LAKES
Organization subpart
Yes
Provider details
NPI number
Legal business name
HACKLEY PROFESSIONAL PHARMACY, INC
Authorized official
KRISTI KAROLE NAGENGAST (VP OF FINANCE)
(231) 728-1950
Entity
Organization
Contact information
Practice address
6401 PRAIRIE ST STE 1100, NORTON SHORES, MI 49444-7839
(231) 672-7821
(231) 727-7971
Mailing address
6401 PRAIRIE ST STE 1100, NORTON SHORES, MI 49444-7839
(231) 672-7821
(231) 727-7971
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301008308
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2042118
PK
—
05
—
2368024
—
MI
Enumeration date
07/30/2006
Last updated
11/10/2022
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