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General NPI Number Information
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NPI Number | 1154944320
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Entity Type | Organization
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Legal Business Name | CEDAR SPRINGS PHARMACY, LLC
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Dates
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Enumeration Date | 05/22/2020
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 14111 WHITE CREEK AVE NE STE 12
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City | CEDAR SPRINGS
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State | MI
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Zip | 49319-8170
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Country | US
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Telephone | 616-439-2779
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Fax | 616-439-2552
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Provider Business Mailing Address
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Address Line | 14111 WHITE CREEK AVE NE STE 12
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City | CEDAR SPRINGS
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State | MI
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Zip | 49319-8170
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | JODI MAKI
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Credential | R.PH., PHARM.D.
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Telephone | 616-439-2779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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