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General NPI Number Information
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NPI Number | 1194767996
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Entity Type | Organization
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Legal Business Name | STATE OF MICHIGAN OFFICE OF FINANCIAL MANAGEMENT
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 2040 CHAMBERS RD
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City | CARO
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State | MI
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Zip | 48723
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Country | US
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Telephone | 989-672-9261
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Fax | 989-673-6749
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Provider Business Mailing Address
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Address Line | PO BOX 30437
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City | LANSING
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State | MI
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Zip | 48909-7937
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Country | US
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Telephone | 517-241-5544
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Fax | 517-335-6995
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Authorized Official
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Title or Position | SENIOR EXECUTIVE
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Name | JEFFERY WIEFERICH
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Credential |
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Telephone | 517-335-0499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 5301000559
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 283Q00000X
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Taxonomy Name | Psychiatric Hospital
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License Number |
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License Number State |
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