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General NPI Number Information
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NPI Number | 1932158599
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Entity Type | Organization
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Legal Business Name | THE PEOPLES DRUG STORE, INC.
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1208 LUDINGTON ST
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City | ESCANABA
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State | MI
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Zip | 49829-3539
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Country | US
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Telephone | 906-786-1731
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Fax | 906-789-6204
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Provider Business Mailing Address
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Address Line | 1208 LUDINGTON ST
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City | ESCANABA
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State | MI
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Zip | 49829-3539
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Country | US
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Telephone | 906-786-1731
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Fax | 906-789-6204
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT LEE BODJANAC
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Credential | R.PH.
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Telephone | 906-786-1731
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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 | 000142
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License Number State | MI
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