NPI 1689965832

Jay McCulloch, RPH

Practitioner Pharmacist East Jordan, MI

Practice location

Address: 250 S Lake St, East Jordan, MI 49727-9376
Phone: (231) 536-0901

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence 5302021369 (MI)

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Registry record

NPI: 1689965832
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Apr 2011
Record last updated: 22 Apr 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.