Healthcare Provider Details

I. General information

NPI: 1366484933
Provider Name (Legal Business Name): REGENTS OF THE UNIVERSITY OF MICHIGAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 02/03/2020
Certification Date: 02/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4260 PLYMOUTH RD
ANN ARBOR MI
48109-2700
US

IV. Provider business mailing address

PO BOX 223010
PITTSBURGH PA
15251-2010
US

V. Phone/Fax

Practice location:
  • Phone: 734-647-5705
  • Fax: 734-232-3408
Mailing address:
  • Phone: 734-647-5705
  • Fax: 734-232-3408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5301006480
License Number StateMI

VIII. Authorized Official

Name: DAVID SPAHLINGER
Title or Position: PRESIDENT
Credential: MD
Phone: 734-936-3568