Healthcare Provider Details

I. General information

NPI: 1962530030
Provider Name (Legal Business Name): CHRISTINA SUSAN OISTEN R.PH.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4410 DIVISION AVE S
KENTWOOD MI
49548-4305
US

IV. Provider business mailing address

1561 WOODHILL CT SW
WYOMING MI
49509-5041
US

V. Phone/Fax

Practice location:
  • Phone: 616-532-9241
  • Fax: 616-406-0158
Mailing address:
  • Phone: 616-249-9795
  • Fax: 616-406-0158

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302026001
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: