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General NPI Number Information
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NPI Number | 1811087943
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Entity Type | Organization
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Legal Business Name | BRANDTS DRUGS
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 02/20/2008
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Provider Practice Location Address
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Address Line | 1964 SO. MOREY RD
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City | LAKE CITY
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State | MI
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Zip | 49651-9380
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Country | US
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Telephone | 231-839-7207
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Fax | 231-839-4142
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Provider Business Mailing Address
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Address Line | BOX 651 1964 SO. MOREY RD
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City | LAKE CITY
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State | MI
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Zip | 49651-9380
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Country | US
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Telephone | 231-839-7207
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Fax | 231-839-4142
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Authorized Official
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Title or Position | PRESIDENT
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Name | GREGORY A BRANDT
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Credential | RPH
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Telephone | 231-839-7207
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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 | 5301003542
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License Number State | MI
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