Country Squire Pharmacy
LBN: Country Squire Discount Pharmacy, Inc
Country Squire Pharmacy is an health care organization with primary practice located at 30 E Main St , Fremont MI 49412-1244. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Country Squire Discount Pharmacy, Inc can be contacted via phone (231) 924-2120, or through Afman, Judson via phone (231) 924-2120.
Contact Information
Primary practice address
30 E Main St
Fremont MI 49412-1244
Phone: (231) 924-2120
Fax: (231) 924-6310
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5301001172 | Michigan |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1265445936 |
|---|---|
| LBN Legal business name | Country Squire Discount Pharmacy, Inc |
| DBA Doing business as | Country Squire Pharmacy |
| Authorized official | Afman, Judson |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Aug 14th, 2006 |
| Last updated | Jul 28th, 2014 - about 11 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1265445936 | NPPES |
| Michigan | MEDICAID | 1878530 | |
| Michigan | Other | 2039663 |
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