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General NPI Number Information
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NPI Number | 1750365540
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Entity Type | Organization
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Legal Business Name | PCI PHARMACY, INC
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 4652 N M 37 HWY
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-8806
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Country | US
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Telephone | 269-795-7936
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Fax |
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Provider Business Mailing Address
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Address Line | 4652 N M 37 HWY
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City | MIDDLEVILLE
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State | MI
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Zip | 49333-8806
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Country | US
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Telephone | 269-795-7936
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KRISTIN JOY RAREDON
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Credential | PHARMD
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Telephone | 269-795-7936
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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 |
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License Number State |
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