Healthcare Provider Details

I. General information

NPI: 1144726191
Provider Name (Legal Business Name): JANUS RX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2018
Last Update Date: 02/19/2026
Certification Date: 02/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 68TH ST SE STE 147
GRAND RAPIDS MI
49548-6927
US

IV. Provider business mailing address

3480 EASTERN BLVD
MONTGOMERY AL
36116-1700
US

V. Phone/Fax

Practice location:
  • Phone: 616-591-3726
  • Fax:
Mailing address:
  • Phone: 334-819-4500
  • Fax: 334-819-4520

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number5301011350
License Number StateMI

VIII. Authorized Official

Name: JANUARY GREEN
Title or Position: VP, HUMAN RESOURCES
Credential:
Phone: 334-819-4500