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General NPI Number Information
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NPI Number | 1306515309
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Entity Type | Organization
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Legal Business Name | HUDSON PHARMACY INC
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Dates
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Enumeration Date | 09/13/2021
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Last Update Date | 09/13/2021
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Provider Practice Location Address
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Address Line | 325 RAILROAD ST STE D
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City | HUDSON
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State | MI
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Zip | 49247-1062
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Country | US
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Telephone | 517-448-3111
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Fax | 517-448-5892
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Provider Business Mailing Address
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Address Line | 1410 W GANSON ST
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City | JACKSON
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State | MI
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Zip | 49202-4063
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Country | US
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Telephone | 517-789-8980
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Fax | 517-789-0115
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Authorized Official
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Title or Position | VP OPERATIONS
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Name | JOANN MARIE SANBORN
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Credential | RPH
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Telephone | 517-448-3111
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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