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General NPI Number Information
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NPI Number | 1932135126
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Entity Type | Organization
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Legal Business Name | CENTRAL PHARMACY-PERRY LLC
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Dates
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Enumeration Date | 06/23/2006
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Last Update Date | 08/21/2020
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Provider Practice Location Address
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Address Line | 150 S. MAIN ST SUITE A
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City | PERRY
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State | MI
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Zip | 48872-9703
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Country | US
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Telephone | 517-625-8640
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Fax | 517-625-8642
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Provider Business Mailing Address
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Address Line | PO BOX 105
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City | PERRY
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State | MI
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Zip | 48872-0105
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Country | US
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Telephone | 517-625-8640
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Fax | 517-625-8642
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Authorized Official
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Title or Position | MEMBER
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Name | DAVID LARNER
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Credential | RPH
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Telephone | 517-410-8581
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301010568
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License Number State | MI
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