Cosalus Health Pllc

NPI 1003152752 - Pharmacist - 1835P0018X

NPI Details
NPI 1003152752
Enumeration Date 12/28/2012
Last Updated 12/28/2012
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name JACK W JACK
Position PRESIDENT
Phone (616) 481-9073
Fax (616) 975-7596
Practice Location
3031 POPLAR CREEK DR SE
SUITE 103
GRAND RAPIDS MI, 49512-5682, US
Phone (616) 481-9073
Fax (616) 975-7596
Business Location
3031 POPLAR CREEK DR SE
SUITE 103
GRAND RAPIDS MI, 49512-5682, US
Phone (616) 481-9073
Fax (616) 975-7596
Toxanomy
Taxonomy Code 1835P0018X
License State Michigan
License Number 5302021538
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According to our database, Cosalus Health Pllc NPI is 1003152752, taxonomy code is 1835P0018X and license number is 5302021538, license state is located at Michigan. Cosalus Health Pllc physically located at 3031 Poplar Creek Dr Se, Grand Rapids MI, 49512-5682. NPI Number 1033115704 has the healthcare provider type.

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1003152752 NPI number is provided on an as is basis without warranty of any kind. 1003152752 is maintained by the National Plan & Provider Enumeration System. The contents of Cosalus Health Pllc are for informational purposes only.