Organization Name: | KMART OF MICHIGAN INC |
NPI Number: | 1336170323 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DALE PURVIS (DIRECTOR OF THIRD PARTY ADMIN) |
Mailing Address: | 2948 S State Rd Ionia |
State: | MI US |
Postal Code: | 488469475 |
Phone Number: | 6165270174 |
Fax Number: | 6165274544 |
NPI Enumeration Date: | 07/06/2006 |
NPI Last Update Date: | 12/26/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |