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General NPI Number Information
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NPI Number | 1922107655
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Entity Type | Organization
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Legal Business Name | ASPIRUS KEWEENAW
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Dates
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Enumeration Date | 09/21/2006
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 205 OSCEOLA ST
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City | LAURIUM
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State | MI
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Zip | 49913-2134
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Country | US
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Telephone | 906-337-6575
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Fax | 906-337-6576
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Provider Business Mailing Address
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Address Line | 205 OSCEOLA ST
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City | LAURIUM
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State | MI
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Zip | 49913-2134
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Country | US
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Telephone | 906-337-6575
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Fax | 906-337-6576
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Authorized Official
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Title or Position | SVP & CHIEF FINANCIAL OFFICER
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Name | JERRY M YANG
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Credential |
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Telephone | 715-847-2526
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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 | 5301006759
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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