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NPI Code Detail

MEDICARE: MAPLECREST FAMILY PHARMACY, INC

MEDICARE: MAPLECREST FAMILY PHARMACY, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy5301008084MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12366816OTHERMINCPDP

General Provider Information

NPI Number : 1316977093
Entity Type Code : Organization
Provider Name (Legal Business Name) : MAPLECREST FAMILY PHARMACY, INC
Provider Business Mailing Address
First Line : 1533 EAST CHICAGO RD
Second Line :
City : STURGIS
State : MI
Zip : 49091
Country : US
Telephone Number : 269-659-4600
Fax Number : 269-639-3608
Provider Business Practice Location Address
First Line : 1533 EAST CHICAGO RD
Second Line :
City : STURGIS
State : MI
Zip : 49091
Country : US
Telephone Number : 269-659-4600
Fax Number : 269-639-3608
Authorized Official
Title or Position : PRESIDENT
Name : MR. LAWRENCE DEAN CURTIS
Credential : R.PH.
Telephone Number : 269-659-4600
Provider Enumeration Date : 07/05/2006
Last Update Date : 08/22/2020

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Directions to “MAPLECREST FAMILY PHARMACY, INC ” Practice Location

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