Healthcare Provider Details
I. General information
NPI: 1528692464
Provider Name (Legal Business Name): HARBOR DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/01/2020
Last Update Date: 03/01/2020
Certification Date: 03/01/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2031 E MAIN ST
UBLY MI
48475-9726
US
IV. Provider business mailing address
114 S HURON AVE
HARBOR BEACH MI
48441-1201
US
V. Phone/Fax
- Phone: 989-315-8605
- Fax: 989-479-3242
- Phone: 989-315-8605
- Fax: 989-479-3242
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3336C0003X |
| Taxonomy | Community/Retail Pharmacy |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MICHAEL
A
DELPIERE
Title or Position: OWNER
Credential: R.PH.
Phone: 989-315-8605