Healthcare Provider Details

I. General information

NPI: 1699725283
Provider Name (Legal Business Name): PINNY PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 03/05/2025
Certification Date: 03/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

704 S MABLE ST
PINCONNING MI
48650-9348
US

IV. Provider business mailing address

704 S MABLE ST PO BOX 777
PINCONNING MI
48650-9348
US

V. Phone/Fax

Practice location:
  • Phone: 989-879-7705
  • Fax: 989-879-6950
Mailing address:
  • Phone: 989-879-7705
  • Fax: 989-879-6950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301007276
License Number StateMI

VIII. Authorized Official

Name: TERESA JEAN SPIES
Title or Position: PRESIDENT
Credential:
Phone: 989-876-8899