Organization · Type 2 NPI

State Street Pharmacy LTC

Long Term Care Pharmacy · Caro, MI

NPI number 1588422158 Active

Practice location

192 N State St
Caro, MI 48723-1550

Fax (989) 672-3555

Specialties and licenses

Taxonomy	Code	License
Long Term Care Pharmacy Primary	3336L0003X	None listed

Long Term Care Pharmacy: A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.

3 other providers at this address

NPI record

NPI: 1588422158
Entity type: Organization (Type 2)
Issued: Mar 8, 2024
Last updated: Mar 8, 2024
Status: Active
Subpart: Yes of State Street Pharmacy and Wellness Center Inc

Other names

<unavail>
State Street Pharmacy LTC · doing business as

Authorized official

Adam Zovishlack
President/owner
(989) 672-3500

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

Is this your record? How to update it.

About NPI 1588422158

State Street Pharmacy LTC's National Provider Identifier is 1588422158, issued on Mar 8, 2024. The primary taxonomy on file is Long Term Care Pharmacy (3336L0003X), and the practice location is in Caro, MI. The record was last updated on Mar 8, 2024.