Healthcare Provider Details

I. General information

NPI: 1093781734
Provider Name (Legal Business Name): GPS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 S MARTIN LUTHER KING JR BLVD SUITE A
LANSING MI
48910-4300
US

IV. Provider business mailing address

3525 S MARTIN LUTHER KING JR BLVD SUITE A
LANSING MI
48910-4300
US

V. Phone/Fax

Practice location:
  • Phone: 517-394-0631
  • Fax: 517-394-0485
Mailing address:
  • Phone: 517-394-0631
  • Fax: 517-394-0485

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number5302030240
License Number StateMI

VIII. Authorized Official

Name: DR. JESSICA PRICE
Title or Position: PHARMACIST
Credential: PHARMD
Phone: 517-394-0631