S. Fountain'S Inc

Organization Active NPI Community/Retail Pharmacy · East Tawas, MI

NPI 1477520377 · NPPES record last updated Mar 7, 2023

Key facts

NPI
1477520377
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
S. FOUNTAIN'S INC
Practice address
133 Newman St
East Tawas, MI 48730
Phone
(989) 362-7415
Fax
(989) 362-0597
NPI assigned
Mar 1, 2006
Organization subpart
No

Authorized official

Name
Mr. Steven Mark Fountain, R.PH.
Title
Owner/Pres
Phone
(989) 362-7415

National Provider Directory

Locations

133 Newman St
East Tawas, MI 48730
Phone (989) 362-7415

Specialties & licenses

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

Addresses

Primary practice location

133 Newman St
East Tawas, MI 48730

Mailing address

133 Newman St
East Tawas, MI 48730
Phone (989) 362-7415

Other identifiers

IdentifierTypeStateIssuer
2803829MedicaidMI
2803794MedicaidMI
2349517OtherMINABP

Other names

  • dba The Medicine Shoppe #1189 Doing business as

Other providers in East Tawas, MI

All providers in East Tawas, MI · Community/Retail Pharmacy in Michigan

Sources for this page

Verify at the official NPI Registry.