Provider Demographics
NPI:1386985356
Name:MURKS VILLAGE MARKET INC
Entity type:Organization
Organization Name:MURKS VILLAGE MARKET INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVE
Authorized Official - Middle Name:
Authorized Official - Last Name:LONGTIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:269-637-8655
Mailing Address - Street 1:407 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:GOBLES
Mailing Address - State:MI
Mailing Address - Zip Code:49055-9724
Mailing Address - Country:US
Mailing Address - Phone:269-628-0035
Mailing Address - Fax:269-628-0037
Practice Address - Street 1:407 S STATE ST
Practice Address - Street 2:
Practice Address - City:GOBLES
Practice Address - State:MI
Practice Address - Zip Code:49055-9724
Practice Address - Country:US
Practice Address - Phone:269-628-0035
Practice Address - Fax:269-628-0037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-15
Last Update Date:2013-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy