Countryside Drug Company II
Organization Active NPI Community/Retail Pharmacy · Lakeview, MI
NPI 1407925282 · NPPES record last updated Oct 16, 2017
Key facts
- NPI
- 1407925282
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 5301004423 (MI)
- Legal business name
- COUNTRYSIDE DRUG COMPANY II
- Practice address
- 9695 N Greenville Rd
Lakeview, MI 48850-9107 - Phone
- (989) 352-8168
- Fax
- (989) 352-6253
- NPI assigned
- Nov 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Susan L Stratton
- Title
- Cfo
- Phone
- (989) 352-8168
Practitioners 1
-
Julie Ann Smith, RPH
National Provider Directory
Locations
9700 N Greenville Rd
Lakeview, MI 48850
Phone (989) 352-8168
9695 N Greenville Rd
Lakeview, MI 48850
Phone (989) 352-8168
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 5301004423 | MI | Yes |
Addresses
Primary practice location
9695 N Greenville Rd
Lakeview, MI 48850-9107
Mailing address
9695 N Greenville Rd
PO Box 527
Lakeview, MI 48850-9107
Phone (989) 352-8168
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1756241 | Medicaid | MI | |
| 2039499 | Other | PK |
Other names
- COUNTRYSIDE PHARMACY
Other providers in Lakeview, MI
- Aris Eye Care P.C.
- Amanda Jo Betke X
- Felisha Ann Bitler
- Sada Mae Brown
- Carina Curtis
- Mark Anthony N Del Castillo
- Denise Joy Docter
- James Vernon Draper
- Steven Arne Fahlen
All providers in Lakeview, 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 Oct 16, 2017. 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.