Provider Demographics
NPI:1831495597
Name:ANCHOR BAY PHARAMCY, INC
Entity Type:Organization
Organization Name:ANCHOR BAY PHARAMCY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:B
Authorized Official - Last Name:HALSTEAD
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:586-725-3737
Mailing Address - Street 1:51006 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-2157
Mailing Address - Country:US
Mailing Address - Phone:586-725-3737
Mailing Address - Fax:576-725-5610
Practice Address - Street 1:51006 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:NEW BALTIMORE
Practice Address - State:MI
Practice Address - Zip Code:48047-2157
Practice Address - Country:US
Practice Address - Phone:586-725-3737
Practice Address - Fax:576-725-5610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-28
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301004295332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy