White Pine Apothecary Inc
Organization Active NPI Pharmacist · White Pine, MI
NPI 1043388366 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1043388366
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacist 183500000X
- License
- 5301002806 (MI)
- Legal business name
- WHITE PINE APOTHECARY INC
- Practice address
- 101 Mineral River Plaza
White Pine, MI 49971-0816 - Phone
- (906) 885-5301
- Fax
- (906) 885-5302
- NPI assigned
- Dec 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Charles Eugene Blezek, RPH
- Title
- President Pharmacist
- Phone
- (906) 885-5301
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | 5301002806 | MI | Yes |
Addresses
Primary practice location
101 Mineral River Plaza
White Pine, MI 49971-0816
Mailing address
PO Box 816
101 Mineral River Plaza
White Pine, MI 49971-0816
Phone (906) 885-5301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2320834 | Medicaid | MI |
Other names
- The Apothecary
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.