Bronson Village Drug, Inc.
Organization Active NPI Community/Retail Pharmacy · Decatur, MI
NPI 1558021931 · NPPES record last updated Dec 27, 2021
Key facts
- NPI
- 1558021931
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- Legal business name
- BRONSON VILLAGE DRUG, INC.
- Practice address
- 108 E Delaware St
Decatur, MI 49045-1151 - Phone
- (269) 423-6770
- NPI assigned
- Dec 27, 2021
- Organization subpart
- No
Authorized official
- Name
- Dr. Jeffrey Robert Stull, PHARM.D.
- Title
- Owner
- Phone
- (269) 655-4402
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Aurora Long Term Care
Locations
108 E Delaware St
Decatur, MI 49045
Phone (269) 423-6770
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | Yes |
Addresses
Primary practice location
108 E Delaware St
Decatur, MI 49045-1151
Mailing address
25344 Red Arrow Hwy
Mattawan, MI 49071-9742
Phone (269) 655-4402
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5301010068 | Other | MI | PHARMACY LICENSE |
Other names
- Decatur Village Pharmacy
Other providers in Decatur, MI
- Linda Arlene Berrington
- Blue Seahorse Inc.
- Bronson Lakeview Hospital
- Lester Burkow
- Decatur Pharmacy
- Kristin Lee Desrosiers
- Druskovich Dental PC
- Carl Charles Druskovich
All providers in Decatur, 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 Dec 27, 2021. 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.