MEDICARE: ADVANCED PHARMACY & NUTRITION CENTER

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	3336C0003X	Community/Retail Pharmacy	L710512	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

General Provider Information

NPI Number	:	1891806394
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PHARMACY & NUTRITION CENTER

Provider Business Mailing Address
First Line	:	3960 HURON ST
Second Line	:	PO BOX 319
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461-6122
Country	:	US
Telephone Number	:	810-688-3090
Fax Number	:	810-688-3791

Provider Business Practice Location Address
First Line	:	3960 HURON ST
Second Line	:
City	:	NORTH BRANCH
State	:	MI
Zip	:	48461-6122
Country	:	US
Telephone Number	:	810-688-3090
Fax Number	:	810-688-3791

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JAMES MICHAEL SADLER
Credential	:	RPH.
Telephone Number	:	810-688-3090

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	08/22/2020

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