| NPI | LastName | FirstName | MidName | Organization | Mailing Address | City | State | Zip |
| 1568091957 | BLUE WATER PHARMACY LLC | 1524 10TH STREET | PORT HURON | MI | 48060 | |||
| 1598092769 | BLUE WATER PHARMACY LLC | 1524 10TH STREET | PORT HURON | MI | 48060 | |||
| 1942871876 | MITTA | MALLA | 1524 10TH ST | PORT HURON | MI | 480605815 |