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General NPI Number Information
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NPI Number | 1952082836
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Entity Type | Individual
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Provider Name | ANDY ROSS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2023
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Last Update Date | 07/25/2023
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Provider Practice Location Address
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Address Line | 14640 PARDEE RD
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City | TAYLOR
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State | MI
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Zip | 48180-4739
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Country | US
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Telephone | 734-374-4210
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Fax |
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Provider Business Mailing Address
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Address Line | 4130 ABBOTT AVE
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City | LINCOLN PARK
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State | MI
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Zip | 48146-4020
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Country | US
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Telephone | 313-574-4738
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302415297
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License Number State | MI
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