Provider Demographics
NPI:1932210358
Name:A&R CORPORATION
Entity Type:Organization
Organization Name:A&R CORPORATION
Other - Org Name:MCBAIN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:231-825-2457
Mailing Address - Street 1:106 N ROLAND ST
Mailing Address - Street 2:PO BOX 55
Mailing Address - City:MC BAIN
Mailing Address - State:MI
Mailing Address - Zip Code:49657-9683
Mailing Address - Country:US
Mailing Address - Phone:231-825-2457
Mailing Address - Fax:231-825-8346
Practice Address - Street 1:106 N ROLAND ST
Practice Address - Street 2:106 ROLAND
Practice Address - City:MC BAIN
Practice Address - State:MI
Practice Address - Zip Code:49657-9683
Practice Address - Country:US
Practice Address - Phone:231-825-2457
Practice Address - Fax:231-825-8346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3336C0003X3336C0003X
MI3336L0003X3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI2318409Medicaid
MI2318409Medicaid