MEDICARE: KNIGHT DRUGS-LANSING 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	302R00000X	Health Maintenance Organization		MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2367933	OTHER	MI	NCPDP
3	1437100617	OTHER	MI	NPI

General Provider Information

NPI Number	:	1437100617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KNIGHT DRUGS-LANSING INC

Provider Business Mailing Address
First Line	:	2520 INDUSTRIAL ROW DR
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48084-7035
Country	:	US
Telephone Number	:	248-540-8066
Fax Number	:	248-540-0112

Provider Business Practice Location Address
First Line	:	1540 LAKE LANSING RD
Second Line	:
City	:	LANSING
State	:	MI
Zip	:	48912-3707
Country	:	US
Telephone Number	:	517-485-9633
Fax Number	:	517-485-9634

Authorized Official
Title or Position	:	PRESIDENT OF OPERATIONS
Name	:	JOHN DEJONGH
Credential	:
Telephone Number	:	248-540-8066

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	07/21/2022

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Directions to “KNIGHT DRUGS-LANSING INC ” Practice Location

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