Hackley Pharmacy- Wolf Lake

LBN: Hackley Pharmacy-Wolf Lake
Hackley Pharmacy- Wolf Lake is an health care organization with primary practice located at 5483 E Apple Ave , Muskegon MI 49442-3070. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Hackley Pharmacy-Wolf Lake can be contacted via phone (231) 788-4087, or through Debruin, Kim via phone (231) 728-4046.

Contact Information

Primary practice address
5483 E Apple Ave Muskegon MI 49442-3070
Phone: (231) 788-4087
Fax: (231) 788-3090
Website:
Map and Directions
Authorized official contact:
Name: Debruin, Kim RPH
Phone: (231) 728-4046

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 5301005301 Michigan

Profile Details

NPI number 1306987268
LBN Legal business name Hackley Pharmacy-Wolf Lake
DBA Doing business as Hackley Pharmacy- Wolf Lake
Authorized official Debruin, Kim RPH
Entity Organization
Organization subpart 1 No
Enumeration date Feb 12th, 2007
Last updated Jul 3rd, 2014 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306987268 NPPES
Michigan MEDICAID 2643897
Michigan Other 2040771

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