Great Lakes R.ph. Corp
Community/Retail Pharmacy
71 124th Ave, Shelbyville
Michigan, 49344
269-672-7774 269-672-7887
Great Lakes R.ph. Corp is a Community/Retail Pharmacy in Shelbyville, Michigan. It is located at 71 124th Ave, Shelbyville and it's customer support contact number is 269-672-7774. The authorized person of Great Lakes R.ph. Corp is Michael A Holtz who is Owner of the pharmacy and his contact number is 269-792-3790. Active license number of Great Lakes R.ph. Corp is 5301007296 for Community/Retail Pharmacy in Michigan. Great Lakes R.ph. Corp accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Great Lakes R.ph. Corp is 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 health care providers, collaborative practice, disease state management, and education classes.
Pharmacy Details:
Great Lakes R.ph. Corp type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Great Lakes R.ph. Corp |
| Type: | Community/Retail Pharmacy |
| Location: | 71 124th Ave, Shelbyville,
Michigan, 49344 |
| Phone: | 269-672-7774 |
| Fax: | 269-672-7887 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Michael A Holtz |
| Position: | Owner |
| Contact Number: | 269-792-3790 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1902970668 |
| NPI Enumeration Date: | 17 Nov, 2006 |
| NPI Last Update On: | 16 Dec, 2019 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Great Lakes R.ph. Corp are as mentioned below.
| Specialization | License Number | State | Status | |
| Community/Retail Pharmacy | 5301007296 | Michigan | Primary | |
| Durable Medical Equipment & Medical Supplies | | Michigan | Secondary | |
| Pharmacy | 5301007296 | Michigan | Secondary | |
Medicare Enrollment:
Great Lakes R.ph. Corp is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 4082773205 | O20081103000609 | Great Lakes R.ph. Corp | PART B SUPPLIER - MASS IMMUNIZATION (ROSTER BILLER ONLY) |
| 4082773205 | O20100930080190 | Great Lakes R.ph. Corp | DME SUPPLIER - PHARMACY |
Products Available:
Great Lakes R.ph. Corp has following products available for sale under medicare.
| Products: |
|---|
| • Blood Glucose Monitors & Supplies: Non-mail Order | • Canes & Crutches |
| • Commodes, Urinals, & Bedpans | • Diabetic Shoes & Inserts: Custom Fabricated |
| • Diabetic Shoes & Inserts: Prefabricated | • Enteral Equipment And/or Supplies |
| • Enteral Nutrients | • Heat & Cold Applications |
| • Nebulizer Equipment & Supplies | • Orthoses: Off-the-shelf |
| • Orthoses: Prefabricated | • Ostomy Supplies |
| • Surgical Dressings | • Walkers |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 71 124th Ave, Po Box 53
Shelbyville, Michigan |
| Zip: | 49344-9772 |
| Phone Number: | 269-672-7774 |
| Fax Number: | 269-672-7887 |
Patients can reach Great Lakes R.ph. Corp at
71 124th Ave, Shelbyville, Michigan or can
call on customer care at 269-672-7774.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.