Healthcare Provider Details

I. General information

NPI: 1447023999
Provider Name (Legal Business Name): MSU HEALTH CARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 11/13/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4660 S HAGADORN RD STE 100
EAST LANSING MI
48823-5353
US

IV. Provider business mailing address

4660 S HAGADORN RD STE 100
EAST LANSING MI
48823-5353
US

V. Phone/Fax

Practice location:
  • Phone: 517-353-3776
  • Fax: 517-353-3510
Mailing address:
  • Phone: 517-353-3776
  • Fax: 517-353-3510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336S0011X
TaxonomySpecialty Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RELANDA PRICE
Title or Position: PROVIDER ENROLLMENT MANGER
Credential:
Phone: 517-884-2976