Healthcare Provider Details

I. General information

NPI: 1629073960
Provider Name (Legal Business Name): HARBOR DRUG INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/14/2005
Last Update Date: 03/01/2020
Certification Date: 03/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

114 S HURON AVE
HARBOR BEACH MI
48441-1201
US

IV. Provider business mailing address

114 S HURON AVE
HARBOR BEACH MI
48441-1201
US

V. Phone/Fax

Practice location:
  • Phone: 989-315-8605
  • Fax: 989-479-3242
Mailing address:
  • Phone: 989-315-8605
  • Fax: 989-479-3242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number5301005688
License Number StateMI

VIII. Authorized Official

Name: MICHAEL A DELPIERE
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 989-315-8605