Healthcare Provider Details

I. General information

NPI: 1184707176
Provider Name (Legal Business Name): CENTRAL PHARMACY - WILLIAMSTON LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 11/14/2023
Certification Date: 11/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

129 S PUTNAM ST
WILLIAMSTON MI
48895-1335
US

IV. Provider business mailing address

129 S PUTNAM ST
WILLIAMSTON MI
48895-1335
US

V. Phone/Fax

Practice location:
  • Phone: 517-992-5101
  • Fax: 517-992-5102
Mailing address:
  • Phone: 517-992-5101
  • Fax: 517-992-5102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMANDA MAE HART
Title or Position: OWNER
Credential:
Phone: 517-992-5101