Organization · Type 2 NPI

Great Lakes Pharmacy Midland, LLC

Community/Retail Pharmacy · Midland, MI

NPI number 1942580972 Active

Practice location

1120 Eastman Ave
Midland, MI 48640-4215

Fax (989) 835-6975

Specialties and licenses

Taxonomy	Code	License
Durable Medical Equipment & Medical Supplies	332B00000X	None listed
Pharmacy	333600000X	None listed
Community/Retail Pharmacy Primary	3336C0003X	5301009642 (MI)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

3 other providers at this address

Other community/retail pharmacy providers in Midland

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NPI record

NPI: 1942580972
Entity type: Organization (Type 2)
Issued: Aug 22, 2011
Last updated: Jul 16, 2026
Status: Active

Other names

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Great Lakes Pharmacy of Midland · doing business as
Great Lakes Pharmacy of Midland · doing business as

Authorized official

Naif Bazzi, PharmD
Owner/ Pharmacist
(313) 208-4550

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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.

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About NPI 1942580972

Great Lakes Pharmacy Midland, LLC's National Provider Identifier is 1942580972, issued on Aug 22, 2011. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Midland, MI. The record was last updated on Jul 16, 2026.