Healthcare Provider Details

I. General information

NPI: 1407681695
Provider Name (Legal Business Name): EXPONENTIAL HEALTH PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/05/2024
Last Update Date: 01/12/2026
Certification Date: 01/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 E PARIS AVE SE STE 220
GRAND RAPIDS MI
49546-6195
US

IV. Provider business mailing address

2155 EAST PARIS AVE SE STE 220
GRAND RAPIDS MI
49546-6195
US

V. Phone/Fax

Practice location:
  • Phone: 616-548-6161
  • Fax:
Mailing address:
  • Phone: 616-548-6161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ADAM AQEL
Title or Position: PHARMACIST IN CHARGE (PIC)
Credential: PHARMD
Phone: 616-206-4316