Healthcare Provider Details

I. General information

NPI: 1538976626
Provider Name (Legal Business Name): WUIS VALUE DRUGS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2024
Last Update Date: 12/12/2024
Certification Date: 12/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

08337 M 140 STE 2
SOUTH HAVEN MI
49090-1990
US

IV. Provider business mailing address

08337 M 140 STE 2
SOUTH HAVEN MI
49090-1990
US

V. Phone/Fax

Practice location:
  • Phone: 269-637-3222
  • Fax: 269-637-4089
Mailing address:
  • Phone: 269-637-3222
  • Fax: 269-637-4089

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: RYAN DAVID MOORE
Title or Position: PRESIDENT
Credential: R.PH., M.B.A.
Phone: 269-637-3222