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Contact Information

HACKLEY PHARMACY NORTON SHORES
3535 PARK ST
STE 104
MUSKEGON, MI49444-3736
 Phone: 231-739-9302
 Fax: 231-728-1604
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
 

Institutional Pharmacy

3336I0012X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for HACKLEY PHARMACY NORTON SHORES

NPI Number 1487793436
LBN Legal business name HACKLEY PHARMACY NORTON SHORES
Authorized official CARLTON BOSSE - (DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 02/22/2008 - About 18 years ago
Identifiers
MI License # 5301008544
MI Medicaid 2369165
Other 2369165 OTHER ID NUMBER
Other 2369165 OTHER ID NUMBER-COMMERCIAL NUMBER
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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