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General NPI Number Information
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NPI Number | 1073617031
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Entity Type | Organization
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Legal Business Name | PARKWOOD PHARMACY LLC
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Dates
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Enumeration Date | 09/12/2006
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Last Update Date | 12/22/2016
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Provider Practice Location Address
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Address Line | 1106 BURTON ST SW
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City | WYOMING
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State | MI
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Zip | 49509-1435
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Country | US
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Telephone | 616-245-2463
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Fax | 616-245-2163
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Provider Business Mailing Address
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Address Line | 1106 BURTON ST SW
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City | WYOMING
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State | MI
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Zip | 49509-1435
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Country | US
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Telephone | 616-245-2463
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Fax | 616-245-2163
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Authorized Official
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Title or Position | CO OWNER
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Name | STEPHEN FELKEY
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Credential | RPH
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Telephone | 616-669-3657
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301008145
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License Number State | MI
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