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General NPI Number Information
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NPI Number | 1760522676
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Entity Type | Organization
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Legal Business Name | WESTERN MICHIGAN UNIVERSITY
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 05/08/2017
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Provider Practice Location Address
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Address Line | NORTH GILKISON AVENUE
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City | KALAMAZOO
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State | MI
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Zip | 49008-5445
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Country | US
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Telephone | 269-387-3355
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Fax | 269-387-2205
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Provider Business Mailing Address
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Address Line | NORTH GILKISON AVENUE SINDECUSE HC PHARMACY
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City | KALAMAZOO
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State | MI
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Zip | 49008-5445
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Country | US
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Telephone | 269-387-3355
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Fax | 269-387-2205
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | MR. JAMES HARRY MIDDLETON
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Credential | R.PH.
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Telephone | 269-387-3355
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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 | 5301002794
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License Number State | MI
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