Provider Information for 1811908320
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WAYLAND VILLAGE DRUG INC
Other Names:Doing Business As:WAYLAND VILLAGE PHARMACYOrganization Subpart: NO
NPI: 1811908320
Last Updated: 2016-06-16
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Details
Name | Value | ||||||||||||
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NPI | 1811908320 | ||||||||||||
Enumeration Date | 2006-08-10 | ||||||||||||
NPI Type | NPI-2 Organization | ||||||||||||
Status | Active | ||||||||||||
Authorized Official Information | Name: MICHEAL SHEA B.S. Pharmacy Title: OWNER Phone: 2697926223 | ||||||||||||
Mailing Address | 300 RENO DR WAYLAND, MI 49348-1277 United States Phone: 269-792-6223 | Fax:269-792-6349 | ||||||||||||
Primary Practice Address | 300 RENO DR WAYLAND, MI 49348-1277 United States Phone: 269-792-6223 | Fax:269-792-6349 | ||||||||||||
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