| NPI | 1992831978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON BEAUCH Manager Pharamcy Third Party Prog 616-791-3346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 133V00000X Dietitian, Registered |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2023-12-14 |