Organization
WYOMING PARK PHARMACY
Active
Other names
WYOMING PARK COMPOUNDING PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL ALAN JENSEN R.PH. (OWNER)
(616) 532-2362
Entity
Organization
Contact information
Practice address
2301 LEE ST SW, WYOMING, MI 49519-1620
(616) 532-2362
(616) 532-7378
Mailing address
2301 LEE ST SW, WYOMING, MI 49519-1620
(616) 532-2362
(616) 532-7378
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
—
—
Other
Enumeration date
03/20/2007
Last updated
08/22/2020
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