Healthcare Provider Details

I. General information

NPI: 1851366280
Provider Name (Legal Business Name): JANICE T GILES PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4055 CASCADE RD SE SUITE 204
GRAND RAPIDS MI
49546
US

IV. Provider business mailing address

4055 CASCADE RD SE SUITE 204
GRAND RAPIDS MI
49546
US

V. Phone/Fax

Practice location:
  • Phone: 616-252-4045
  • Fax: 616-252-4092
Mailing address:
  • Phone: 616-252-4045
  • Fax: 616-252-4092

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302033469
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: