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GREAT LAKES COMPOUNDING PHARMACY

Medical Equipment Supplier Yellow Pages

Grand Haven, Michigan

Provider NPI: 1720272016

Organization Information:
Organization Name:  GREAT LAKES COMPOUNDING PHARMACY


Practice Location:
1445 SHELDON RD 104A GRAND HAVEN, MI 49417 US
Tel: 616-842-1223  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N3336C0004XSuppliers
Pharmacy
Compounding Pharmacy
Y3336C0003XSuppliers
Pharmacy
MI5301008607

Other Provider Identifiers:

IssuerNumberStateType
OTHER ID NUMBER236965801
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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