Provider Demographics
NPI:1821873696
Name:PCI PHARMACY, INC
Entity Type:Organization
Organization Name:PCI PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:JOY
Authorized Official - Last Name:RAREDON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:269-795-7936
Mailing Address - Street 1:4652 N M 37 HWY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:49333-8806
Mailing Address - Country:US
Mailing Address - Phone:269-795-7936
Mailing Address - Fax:269-795-4928
Practice Address - Street 1:4652 N M 37 HWY
Practice Address - Street 2:
Practice Address - City:MIDDLEVILLE
Practice Address - State:MI
Practice Address - Zip Code:49333-8806
Practice Address - Country:US
Practice Address - Phone:269-795-7936
Practice Address - Fax:269-795-4928
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-29
Last Update Date:2023-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy