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General NPI Number Information
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NPI Number | 1174346233
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MICHIGAN HEALTH-WEST OUTPATIENT PHARMACY
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Dates
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Enumeration Date | 11/06/2024
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Last Update Date | 11/06/2024
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Provider Practice Location Address
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Address Line | 5900 BYRON CENTER AVE SW STE 101
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City | WYOMING
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State | MI
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Zip | 49519-9606
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Country | US
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Telephone | 616-252-7979
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Fax | 616-252-7175
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Provider Business Mailing Address
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Address Line | 5900 BYRON CENTER AVE SW STE 101
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City | WYOMING
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State | MI
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Zip | 49519-9606
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Country | US
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Telephone | 616-252-7979
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Fax | 616-252-7175
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY SERVICES
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Name | PETER JOSEPH HAVERKAMP
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Credential | R.PH.
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Telephone | 616-252-7216
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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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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