Shoreline Pharmacy
LBN: Randall Scott Davis
Shoreline Pharmacy is an health care organization with primary practice located at 901 S Bailey Ave Ste 3 , South Haven MI 49090-6745. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty.
Randall Scott Davis can be contacted via phone (269) 637-9476, or through Davis, Randall Scott via phone (269) 637-9476.
Contact Information
Primary practice address
901 S Bailey Ave Ste 3
South Haven MI 49090-6745
Phone: (269) 637-9476
Fax: (269) 639-1650
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Suppliers / Community/Retail Pharmacy | 3336C0003X | 5302025949 | Michigan |
Profile Details
NPI number | 1578513479 |
---|---|
LBN Legal business name | Randall Scott Davis |
DBA Doing business as | Shoreline Pharmacy |
Authorized official | Davis, Randall Scott |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | May 11th, 2006 |
Last updated | Feb 28th, 2017 - about 7 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 | 1578513479 | NPPES |
Michigan | MEDICAID | 2726327 |
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