Healthcare Provider Details

I. General information

NPI: 1932167707
Provider Name (Legal Business Name): COMPUTER HEALTH SERVICES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2006
Last Update Date: 05/15/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 FULTON ST E SUITE 28
GRAND RAPIDS MI
49503-3200
US

IV. Provider business mailing address

233 FULTON ST E SUITE 28
GRAND RAPIDS MI
49503-3200
US

V. Phone/Fax

Practice location:
  • Phone: 616-458-6967
  • Fax: 616-458-6991
Mailing address:
  • Phone: 616-458-6967
  • Fax: 616-458-6991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KYLE A RASIKAS
Title or Position: PRESIDENT
Credential:
Phone: 616-458-6967