Healthcare Provider Details

I. General information

NPI: 1508106121
Provider Name (Legal Business Name): MURKS VILLAGE MARKET INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/19/2013
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108B EAST DELAWARE STREET
DECATUR MI
49045
US

IV. Provider business mailing address

108B EAST DELAWARE STREET
DECATUR MI
49045
US

V. Phone/Fax

Practice location:
  • Phone: 269-423-6770
  • Fax: 269-423-6794
Mailing address:
  • Phone: 269-423-6770
  • Fax: 269-423-6794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LINDA BERRINGTON
Title or Position: PHARMACY MANAGER
Credential:
Phone: 269-423-6770