Healthcare Provider Details

I. General information

NPI: 1518331966
Provider Name (Legal Business Name): LINDSEY WESTERHOF PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2015
Last Update Date: 09/07/2021
Certification Date: 09/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 BROADWAY AVE NW
GRAND RAPIDS MI
49504-4462
US

IV. Provider business mailing address

546 GLENWOOD AVE SE
GRAND RAPIDS MI
49506-2703
US

V. Phone/Fax

Practice location:
  • Phone: 616-685-8682
  • Fax:
Mailing address:
  • Phone: 616-430-0726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License Number5302040259
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: