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General NPI Number Information
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NPI Number | 1215677349
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Entity Type | Organization
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Legal Business Name | WADHAMS CORNER PHARMACY, LLC
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Dates
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Enumeration Date | 03/29/2022
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 5283 LAPEER RD
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City | KIMBALL
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State | MI
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Zip | 48074-1422
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Country | US
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Telephone | 810-325-1761
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Fax |
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Provider Business Mailing Address
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Address Line | 5283 LAPEER RD
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City | KIMBALL
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State | MI
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Zip | 48074-1422
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | KAREN HENNESEY
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Credential | RPH
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Telephone | 810-242-1001
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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