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Contact Information

HACKLEY PROFESSIONAL PHARMACY
905 E COLBY ST
WHITEHALL, MI49461-1262
 Phone: 231-728-5974
 Fax: 231-728-1604
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Compounding Pharmacy

3336C0004X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for HACKLEY PROFESSIONAL PHARMACY

NPI Number 1578602520
LBN Legal business name HACKLEY PROFESSIONAL PHARMACY
Authorized official CARLTON BOSSE - (DIRECTOR OF PHARMACY)
Entity Organization
Organization subpart 1 No
Enumeration date 02/06/2007
Last updated 04/30/2009 - About 17 years ago
Identifiers
MI License # 1852218
Other 2369153 NCPDP PROVIDER IDENTIFICATION 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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