STATE OF MICHIGAN NPI 1093819229

NPI Information

STATE OF MICHIGAN is a long term care pharmacy pharmacy in Grand Rapids, MI. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities for mentally retarded, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. STATE OF MICHIGAN NPI is 1093819229. The provider is registered as an organization entity type.
The provider Is Doing Business As Grand Rapids Home For Veterans.

The provider's business location address is:

3000 MONROE AVE NE
GRAND RAPIDS, MI
ZIP 49505-313
Phone: (616) 364-5355
Fax: (616) 364-5260

The provider's authorized official is John William Carlson .
The authorized official title is Director Of Pharmacy and has the following contact phone number (616) 364-5355.

The enumeration date for this NPI number is 9/8/2006 and was last updated on 10/19/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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