Provider Demographics
NPI:1609469246
Name:ENCAPSULATE LLC
Entity Type:Organization
Organization Name:ENCAPSULATE LLC
Other - Org Name:ALLY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:M
Authorized Official - Last Name:STURM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:989-670-3190
Mailing Address - Street 1:1800 W CARO RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CARO
Mailing Address - State:MI
Mailing Address - Zip Code:48723-8209
Mailing Address - Country:US
Mailing Address - Phone:989-589-0069
Mailing Address - Fax:888-626-5688
Practice Address - Street 1:1800 W CARO RD STE 1
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-8209
Practice Address - Country:US
Practice Address - Phone:989-589-0069
Practice Address - Fax:888-626-5688
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-15
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy