Olivet Pharmacy Inc
Organization Active NPI Community/Retail Pharmacy · Olivet, MI
NPI 1124060652 · NPPES record last updated Sep 27, 2011
Key facts
- NPI
- 1124060652
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 5301000875 (MI)
- Legal business name
- OLIVET PHARMACY INC
- Practice address
- 102 Washington St
Olivet, MI 49076-9462 - Phone
- (269) 749-2301
- Fax
- (269) 749-2301
- NPI assigned
- Jun 11, 2006
- Organization subpart
- No
Authorized official
- Name
- Glenda King, RPH
- Title
- President and Owner
- Phone
- (269) 749-2301
National Provider Directory
Locations
102 Washington St
Olivet, MI 49076
Phone (269) 749-2301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 5301000875 | MI | Yes |
Addresses
Primary practice location
102 Washington St
Olivet, MI 49076-9462
Mailing address
PO Box 537
Olivet, MI 49076-0537
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2318978 | Other | NCPDP PROVIDER IDENTIFICATION NUMBER | |
| 1737040 | Medicaid | MI |
Other names
- OLIVET PHARMACY
Other providers in Olivet, MI
- Main Street Dental PLLC
- Deanna L Mistretta
- Wendy Jo Murray
- Next Step Home Health and Staffing, LLC
- Olivet College
- Olivet Pharmacy LLC
- Britney Page
- Zackary Scott Perry
- Daniel John Peterson
- Chacko Joseph Puthentharayil
All providers in Olivet, MI · Community/Retail Pharmacy in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 27, 2011. 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.