Healthcare Provider Details

I. General information

NPI: 1235226937
Provider Name (Legal Business Name): JOHN M LOZEN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37912 POINTE ROSA ST
HARRISON TOWNSHIP MI
48045-2755
US

IV. Provider business mailing address

37912 POINTE ROSA ST
HARRISON TOWNSHIP MI
48045-2755
US

V. Phone/Fax

Practice location:
  • Phone: 586-468-5835
  • Fax:
Mailing address:
  • Phone: 586-468-5835
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302020093
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: