Healthcare Provider Details

I. General information

NPI: 1689694549
Provider Name (Legal Business Name): MARK E. SCHLOTT RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S CREYTS RD
LANSING MI
48917-8507
US

IV. Provider business mailing address

3951 BLUE SPRUCE DR
DEWITT MI
48820-9259
US

V. Phone/Fax

Practice location:
  • Phone: 517-322-8200
  • Fax: 517-322-8242
Mailing address:
  • Phone: 517-322-8200
  • Fax: 517-322-8242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302023747
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: