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General NPI Number Information
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NPI Number | 1750347340
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Entity Type | Organization
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Legal Business Name | GPS OF MICHIGAN LLC
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1201 FLUSHING RD
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City | FLINT
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State | MI
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Zip | 48504-4730
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Country | US
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Telephone | 810-232-1351
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Fax | 810-232-9270
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Provider Business Mailing Address
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Address Line | 1201 FLUSHING RD
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City | FLINT
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State | MI
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Zip | 48504-4730
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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 | OWNER
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Name | FREDERICK GHANNAM
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Credential |
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Telephone | 810-232-9270
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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 | 5301007108
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License Number State | MI
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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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