Healthcare Provider Details

I. General information

NPI: 1588003149
Provider Name (Legal Business Name): ELIZABETH ANNE RETZ RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2013
Last Update Date: 06/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3340 HOSPITAL RD
SAGINAW MI
48603-9622
US

IV. Provider business mailing address

3002 SHREEVE ST
MIDLAND MI
48642-5065
US

V. Phone/Fax

Practice location:
  • Phone: 989-790-7700
  • Fax:
Mailing address:
  • Phone: 989-486-1861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302039022
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: