Healthcare Provider Details

I. General information

NPI: 1801943360
Provider Name (Legal Business Name): HALE PHARMACY,INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 HURON BOX 348
AU GRES MI
48703
US

IV. Provider business mailing address

207 W.HURON BOX 348
AU GRES MI
48703
US

V. Phone/Fax

Practice location:
  • Phone: 989-876-8899
  • Fax: 989-876-6816
Mailing address:
  • Phone: 989-876-8899
  • Fax: 989-876-6816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301004956
License Number StateMI

VIII. Authorized Official

Name: LAWRENCE D CLARK
Title or Position: OWNER PHARMACIST
Credential:
Phone: 989-728-9711