MEDICARE: STUDENT HEALTH SERVICES PHCY

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	3336C0003X	Community/Retail Pharmacy	5301002571	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2040967	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982640504
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STUDENT HEALTH SERVICES PHCY

Provider Business Mailing Address
First Line	:	FOUST HALL 106
Second Line	:
City	:	MT PLEASANT
State	:	MI
Zip	:	48859-0001
Country	:	US
Telephone Number	:	989-774-6590
Fax Number	:	989-774-6665

Provider Business Practice Location Address
First Line	:	CENTRAL MICHIGAN UNIVERSITY
Second Line	:	FOUST HALL 106
City	:	MT PLEASANT
State	:	MI
Zip	:	48859-0001
Country	:	US
Telephone Number	:	989-774-6590
Fax Number	:	989-744-6665

Authorized Official
Title or Position	:	PHARMACY DIRECTOR
Name	:	ERIC CURTISS
Credential	:	PHARMD
Telephone Number	:	989-774-6590

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	10/07/2015

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Directions to “STUDENT HEALTH SERVICES PHCY ” Practice Location

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