Provider Demographics
NPI:1699829556
Name:NORTHWEST SYNERGY INC.
Entity Type:Organization
Organization Name:NORTHWEST SYNERGY INC.
Other - Org Name:COMMUNITY DRUG BENZONIA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:L
Authorized Official - Last Name:GUILLARD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:231-882-4311
Mailing Address - Street 1:1693 BENZIE HIGHWAY PO 60
Mailing Address - Street 2:
Mailing Address - City:BENZONIA
Mailing Address - State:MI
Mailing Address - Zip Code:49616-0060
Mailing Address - Country:US
Mailing Address - Phone:231-882-4311
Mailing Address - Fax:231-882-9411
Practice Address - Street 1:1693 BENZIE HWY
Practice Address - Street 2:
Practice Address - City:BENZONIA
Practice Address - State:MI
Practice Address - Zip Code:49616-0060
Practice Address - Country:US
Practice Address - Phone:231-882-4311
Practice Address - Fax:231-882-9411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy