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General NPI Number Information
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NPI Number | 1841231271
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Entity Type | Organization
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Legal Business Name | WEST SHORE PROFESSIONAL PHARMACY INC
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Dates
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Enumeration Date | 06/09/2006
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Last Update Date | 08/23/2016
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Provider Practice Location Address
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Address Line | 1150 E SHERMAN BOULAVARD SUITE 1400
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City | MUSKEGON
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State | MI
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Zip | 49444-1870
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Country | US
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Telephone | 231-672-2204
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Fax | 231-672-3799
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Provider Business Mailing Address
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Address Line | 1150 E SHERMAN BOULAVARD SUITE 1400
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City | MUSKEGON
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State | MI
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Zip | 49444-1870
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Country | US
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Telephone | 231-672-2204
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Fax | 231-672-3799
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Authorized Official
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Title or Position | VICE PRESIDENT FINANCE
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Name | KRISTI NAGENGAST
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Credential |
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Telephone | 231-728-1950
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 5301003135
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License Number State | MI
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