Provider Demographics
NPI:1306535406
Name:THUNDER BAY COMMUNITY HEALTH SERVICE, INC.
Entity type:Organization
Organization Name:THUNDER BAY COMMUNITY HEALTH SERVICE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:WINEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPHD
Authorized Official - Phone:989-785-5535
Mailing Address - Street 1:PO BOX 427
Mailing Address - Street 2:
Mailing Address - City:HILLMAN
Mailing Address - State:MI
Mailing Address - Zip Code:49746-0427
Mailing Address - Country:US
Mailing Address - Phone:989-354-2197
Mailing Address - Fax:989-354-1952
Practice Address - Street 1:1910 E MILLER RD
Practice Address - Street 2:
Practice Address - City:FAIRVIEW
Practice Address - State:MI
Practice Address - Zip Code:48621-8731
Practice Address - Country:US
Practice Address - Phone:989-848-4606
Practice Address - Fax:989-318-4606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2023-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy