Healthcare Provider Details

I. General information

NPI: 1407949845
Provider Name (Legal Business Name): ALCONA CITIZENS FOR HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 08/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1185 US HIGHWAY 23 N
ALPENA MI
49707-8004
US

IV. Provider business mailing address

PO BOX 655
ALPENA MI
49707
US

V. Phone/Fax

Practice location:
  • Phone: 989-358-3950
  • Fax: 989-358-3720
Mailing address:
  • Phone: 989-358-3950
  • Fax: 989-358-3720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301007867
License Number StateMI

VIII. Authorized Official

Name: CHRISTINE BAUMGARDNER
Title or Position: CEO
Credential:
Phone: 989-736-8157