Beaverton Family Pharmacy LLC

Organization Active NPI Community/Retail Pharmacy · Beaverton, MI

NPI 1194555201 · NPPES record last updated Aug 5, 2024

Key facts

NPI
1194555201
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
BEAVERTON FAMILY PHARMACY LLC
Practice address
3210 W Lang Rd
Beaverton, MI 48612-8102
Phone
(989) 339-9008
Fax
(855) 855-4919
NPI assigned
Aug 5, 2024
Organization subpart
No

Authorized official

Name
John Gross, RPH
Title
Owner
Phone
(989) 339-9008

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Beaverton Family Pharmacy (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

3210 W Lang Rd
Beaverton, MI 48612-8102

Mailing address

11271 Harrison Ave
Farwell, MI 48622-9439
Phone (989) 339-9008

Other names

  • BEAVERTON FAMILY PHARMACY Doing business as

Other providers in Beaverton, MI

All providers in Beaverton, MI · Community/Retail Pharmacy in Michigan

Sources for this page

Verify at the official NPI Registry.