Healthcare Provider Details

I. General information

NPI: 1255462818
Provider Name (Legal Business Name): SCOTT CARL REUSZE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 W GRAND RIVER AVE
BRIGHTON MI
48116-2904
US

IV. Provider business mailing address

3921 FLINT RD
BRIGHTON MI
48114-4903
US

V. Phone/Fax

Practice location:
  • Phone: 810-220-5840
  • Fax: 810-220-0283
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302029911
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: