Organization
PROFESSIONAL PHARMACY INC
Active
Other names
Professional Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN RAREDON (OWNER)
(616) 891-1116
Entity
Organization
Contact information
Practice address
9175 CHERRY VALLEY AVE SE, CALEDONIA, MI 49316-9746
(616) 891-1116
(616) 891-0080
Mailing address
9175 CHERRY VALLEY AVE SE, CALEDONIA, MI 49316-9746
(616) 891-1116
(616) 891-0080
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5301004303
MI
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2339679
—
MI
Enumeration date
09/16/2006
Last updated
03/02/2017
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