Healthcare Provider Details

I. General information

NPI: 1023302296
Provider Name (Legal Business Name): ROSS SCHULTHEISS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2011
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 MICHIGAN ST NE
GRAND RAPIDS MI
49503-2562
US

IV. Provider business mailing address

145 MICHIGAN ST NE
GRAND RAPIDS MI
49503-2562
US

V. Phone/Fax

Practice location:
  • Phone: 616-977-4840
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302037332
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: