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General NPI Number Information
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NPI Number | 1497896351
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Entity Type | Organization
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Legal Business Name | HACKLEY PROFESSIONAL PHARMACY, INC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 12/16/2024
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Provider Practice Location Address
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Address Line | 1675 LEAHY ST SUITE 111
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City | MUSKEGON
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State | MI
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Zip | 49442-5500
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Country | US
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Telephone | 231-672-7822
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Fax | 231-728-4093
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Provider Business Mailing Address
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Address Line | 1675 LEAHY ST SUITE 111
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City | MUSKEGON
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State | MI
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Zip | 49442-5500
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Country | US
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Telephone | 231-672-7822
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Fax | 231-728-4093
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | GARY ALLORE
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Credential |
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Telephone | 231-672-4809
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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 | 5301005276
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License Number State | MI
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