Provider Information for 1689731812
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L'ANSE PHARMACY INC.
Organization Subpart: NO
NPI: 1689731812
Last Updated: 2013-02-07
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||||||
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| NPI | 1689731812 | ||||||||||||
| Enumeration Date | 2007-01-03 | ||||||||||||
| NPI Type | NPI-2 Organization | ||||||||||||
| Status | Active | ||||||||||||
| Authorized Official Information | Name: ALAN HENDRICKS RPh Title: president Phone: 9065246202 | ||||||||||||
| Mailing Address | 18341 US HWY 41 L'ANSE, MI 49946 United States Phone: 906-524-6202 | Fax:906-524-7702 | ||||||||||||
| Primary Practice Address | 18341 US HWY 41 L'ANSE, MI 49946 United States Phone: 906-524-6202 | Fax:906-524-7702 | ||||||||||||
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