Healthcare Provider Details

I. General information

NPI: 1720694003
Provider Name (Legal Business Name): BRITTNIE MROUEH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2020
Last Update Date: 09/22/2020
Certification Date: 09/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 S CEDAR ST
LANSING MI
48910-3028
US

IV. Provider business mailing address

653 GLENWYTH RD
BRIGHTON MI
48116-1770
US

V. Phone/Fax

Practice location:
  • Phone: 517-272-9190
  • Fax:
Mailing address:
  • Phone: 906-440-2389
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302412324
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: