Organization
PORTAGE PHARMACY, INC.
Active
Other names
PORTAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE CURTIS R.PH. (VICE PRESIDENT)
(269) 327-0033
Entity
Organization
Contact information
Practice address
7966 LOVERS LN, PORTAGE, MI 49002-4446
(269) 327-0033
(269) 327-2709
Mailing address
7966 LOVERS LN, PORTAGE, MI 49002-4446
(269) 327-0033
(269) 327-2709
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
5301002930
MI
3336C0003X
Community/Retail Pharmacy
035724
NY
3336C0003X
Community/Retail Pharmacy
Primary
054.017842
IL
3336C0003X
Community/Retail Pharmacy
1994-43
WI
3336C0003X
Community/Retail Pharmacy
NP000798
PA
3336C0003X
Community/Retail Pharmacy
NRP.022791200-03
OH
3336C0004X
Compounding Pharmacy
64002337A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2040070
PK
—
05
—
2527217
—
MI
Enumeration date
07/05/2006
Last updated
07/19/2018
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