Great Lakes Compounding Pharmacy
LBN: Great Lakes Compounding Pharmacy
Great Lakes Compounding Pharmacy is an health care organization with primary practice located at 1445 Sheldon Rd 104A, Grand Haven MI 49417-2480. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Great Lakes Compounding Pharmacy can be contacted via phone (616) 842-1223, or through Tussing, Darcy via phone (616) 847-5230.
Contact Information
Primary practice address
1445 Sheldon Rd 104A
Grand Haven MI 49417-2480
Phone: (616) 842-1223
Fax: (616) 842-0930
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 5301008607 | Michigan |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1720272016 |
|---|---|
| LBN Legal business name | Great Lakes Compounding Pharmacy |
| DBA Doing business as | |
| Authorized official | Tussing, Darcy RPH |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Aug 30th, 2007 |
| Last updated | Jul 8th, 2008 - about 17 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 | 1720272016 | NPPES |
| Other | 2369658 | OTHER ID NUMBER |
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