Organization
PUTVIN HEALTH MART OF MUNISING INC
Active
Other names
Putvin Drug Store A Radio Shack Dealer
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY ALAN DEFRANCESCO RPH (OWNER)
(906) 387-2248
Entity
Organization
Contact information
Practice address
119 ELM AVE, MUNISING, MI 49862-1105
(906) 387-2248
(906) 387-3852
Mailing address
119 ELM AVE, PO BOX 220, MUNISING, MI 49862-1105
(906) 387-2248
(906) 387-3852
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301000415
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2514746
—
MI
Enumeration date
10/11/2006
Last updated
12/03/2019
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