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General NPI Number Information
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NPI Number | 1417055567
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Entity Type | Organization
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Legal Business Name | MISSION PHARMACY, LLC
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 926 S MISSION
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City | MT PLEASANT
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State | MI
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Zip | 48858
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Country | US
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Telephone | 989-773-8200
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Fax | 989-773-8282
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Provider Business Mailing Address
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Address Line | 926 S MISSION
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City | MT PLEASANT
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State | MI
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Zip | 48858
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Country | US
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Telephone | 989-773-8200
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Fax | 989-773-8282
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Authorized Official
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Title or Position | MEMBER
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Name | MS. LISA LOUISE LUNDAHL
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Credential | RPH
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Telephone | 989-773-8200
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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 | 5301006573
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License Number State | MI
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