Provider Demographics
NPI:1801943360
Name:HALE PHARMACY,INC.
Entity type:Organization
Organization Name:HALE PHARMACY,INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:D
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:989-728-9711
Mailing Address - Street 1:207 W.HURON
Mailing Address - Street 2:BOX 348
Mailing Address - City:AU GRES
Mailing Address - State:MI
Mailing Address - Zip Code:48703
Mailing Address - Country:US
Mailing Address - Phone:989-876-8899
Mailing Address - Fax:989-876-6816
Practice Address - Street 1:207 HURON
Practice Address - Street 2:BOX 348
Practice Address - City:AU GRES
Practice Address - State:MI
Practice Address - Zip Code:48703
Practice Address - Country:US
Practice Address - Phone:989-876-8899
Practice Address - Fax:989-876-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010049563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy