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General NPI Number Information
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NPI Number | 1558405217
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Entity Type | Organization
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Legal Business Name | ROOS PHARMACY NORTH, INC.
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Dates
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Enumeration Date | 02/16/2007
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Last Update Date | 05/22/2013
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Provider Practice Location Address
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Address Line | 2370 GREENWOOD RD
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City | PRESCOTT
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State | MI
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Zip | 48756-9655
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Country | US
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Telephone | 989-873-1478
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Fax | 989-873-1475
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Provider Business Mailing Address
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Address Line | 2370 GREENWOOD RD P.O. BOX 4033
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City | PRESCOTT
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State | MI
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Zip | 48756-9655
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Country | US
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Telephone | 989-873-1478
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Fax | 989-873-1475
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Authorized Official
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Title or Position | PRESIDENT PHARMACIST
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Name | MR. EDWARD ROOS
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Credential | RPH.
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Telephone | 989-873-1478
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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 | 5301003126
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License Number State | MI
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