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A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Long Term Care Pharmacy |
3336L0003X | 58 | Medical Supply Company with Pharmacist | |
Institutional Pharmacy |
3336I0012X | 58 | Medical Supply Company with Pharmacist | |
Pharmacy |
333600000X | 58 | Medical Supply Company with Pharmacist |
| NPI # | 1952704843 |
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| LBN Legal business name | STATE OF MICHIGAN | ||||||||||||
| Authorized official | BRADLEY HARVALA - (PHARMACY DIRECTOR) | ||||||||||||
| Entity | Organization | ||||||||||||
| Organization subpart 1 | No | ||||||||||||
| Enumeration date | 10/06/2014 | ||||||||||||
| Last updated | 03/22/2017 - About 9 years ago | ||||||||||||
| Identifiers |
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STATE OF MICHIGAN
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STATE OF MICHIGAN