Healthcare Provider Details

I. General information

NPI: 1114838208
Provider Name (Legal Business Name): ASIA JASMINE JOHNSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 MICHIGAN ST NE FL 7
GRAND RAPIDS MI
49503-2531
US

IV. Provider business mailing address

645 CALIFORNIA ST NW UNIT 1
GRAND RAPIDS MI
49504-5673
US

V. Phone/Fax

Practice location:
  • Phone: 616-391-2802
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835S0206X
TaxonomySolid Organ Transplant Pharmacist
License Number5302415365
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: