Organization
AGS HOLDING LLC
Active
Organization
AGS HOLDING LLC
Active
Other names
Anson Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LAP PAN CHU RPH (OWNER, PIC)
(419) 699-5539
Entity
Organization
Contact information
Practice address
8926 LEWIS AVE, TEMPERANCE, MI 48182-1607
(734) 568-6688
(734) 568-6088
Mailing address
8926 LEWIS AVE, TEMPERANCE, MI 48182-1607
(734) 568-6688
(734) 568-6088
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010542
MI
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146730
PK
—
Enumeration date
07/02/2014
Last updated
04/05/2016
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