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General NPI Number Information
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NPI Number | 1568562833
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Entity Type | Organization
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Legal Business Name | CADILLAC FAMILY PHARMACY LLC
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 04/29/2021
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Provider Practice Location Address
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Address Line | 108 N MITCHELL ST
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City | CADILLAC
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State | MI
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Zip | 49601-2713
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Country | US
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Telephone | 231-775-8200
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Fax | 231-775-8099
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Provider Business Mailing Address
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Address Line | 108 N MITCHELL ST
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City | CADILLAC
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State | MI
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Zip | 49601-2713
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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 | MEMBER
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Name | LISA LUNDAHL
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Credential | BS PHARMACY
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Telephone | 231-775-8200
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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 | 5301007026
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License Number State | MI
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