Healthcare Provider Details

I. General information

NPI: 1013493733
Provider Name (Legal Business Name): PHARMASCRIPT OF MICHIGAN GR LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2018
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2661 29TH ST. SE SUITE A
GRAND RAPIDS MI
49512
US

IV. Provider business mailing address

2661 29TH ST. SE SUITE A
GRAND RAPIDS MI
49512
US

V. Phone/Fax

Practice location:
  • Phone: 616-947-3500
  • Fax: 616-947-8643
Mailing address:
  • Phone: 616-947-3500
  • Fax: 616-947-8643

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SHADIA TURFAH
Title or Position: OWNER
Credential:
Phone: 313-737-0691