Healthcare Provider Details

I. General information

NPI: 1467083485
Provider Name (Legal Business Name): MSU HEALTH CARE INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/29/2020
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

804 SERVICE RD RM 101A
EAST LANSING MI
48824-7015
US

V. Phone/Fax

Practice location:
  • Phone: 517-355-0086
  • Fax: 517-355-4738
Mailing address:
  • Phone: 517-214-5740
  • Fax: 517-355-4738

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SANDRA ANGELA CAMPBELL
Title or Position: PHARMACY DIRECTOR
Credential: PHARM D.
Phone: 517-353-3776