Organization
GREAT LAKES RPH CORP
Active
Other names
Woodpointe Pharmacy Corp
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL HOLTZ (PHARMACIST)
(269) 672-7774
Entity
Organization
Contact information
Practice address
2500 E BELTLINE AVE SE STE O, GRAND RAPIDS, MI 49546-5987
(616) 949-4499
(616) 949-9890
Mailing address
2500 E BELTLINE AVE SE, SUITE O, GRAND RAPIDS, MI 49546-5987
(616) 949-4499
(616) 949-9890
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301009259
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2123017
PK
—
Enumeration date
12/14/2009
Last updated
07/24/2015
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