Divinicare Llc

NPI 1114345907 - Pharmacy - 3336L0003X

NPI Details
NPI 1114345907
Enumeration Date 03/31/2014
Last Updated 06/10/2015
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name MATTHEW MATTHEW
Position RPH/OWNER
Phone (231) 745-4697
Fax (231) 745-8640
Practice Location
868 MICHIGAN AVE STE A
BALDWIN MI, 49304-7123, US
Phone (231) 745-4697
Fax (231) 745-8640
Business Location
PO BOX 310
SUITE A
BALDWIN MI, 49304-0310, US
Phone (231) 745-4697
Fax (231) 745-8640
Toxanomy
Taxonomy Code 3336L0003X
License State Michigan
License Number 5301010379
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According to our database, Divinicare Llc NPI is 1114345907, taxonomy code is 3336L0003X and license number is 5301010379, license state is located at Michigan. Divinicare Llc physically located at 868 Michigan Ave Ste A, Baldwin MI, 49304-7123. NPI Number 1033115704 has the healthcare provider type.

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1114345907 NPI number is provided on an as is basis without warranty of any kind. 1114345907 is maintained by the National Plan & Provider Enumeration System. The contents of Divinicare Llc are for informational purposes only.