MEDICARE: HEALTHPLUS SPECIALTY PHARMACY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336L0003X	Long Term Care Pharmacy	5301009341	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2124951	OTHER		PK

General Provider Information

NPI Number	:	1265769657
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHPLUS SPECIALTY PHARMACY INC

Provider Business Mailing Address
First Line	:	45300 HANFORD RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2695
Country	:	US
Telephone Number	:	734-769-1300
Fax Number	:	734-769-1700

Provider Business Practice Location Address
First Line	:	45300 HANFORD RD
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48187-2695
Country	:	US
Telephone Number	:	734-769-1300
Fax Number	:	734-769-1700

Authorized Official
Title or Position	:	OWNER
Name	:	INDU JOSHI
Credential	:
Telephone Number	:	734-891-1727

Provider Enumeration Date	:	11/05/2009
Last Update Date	:	04/23/2013

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