Organization
WEST MICHIGAN CANCER CENTER
Active
Other names
West Michigan Cancer Center Retail Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH MIRRO (CMO)
(269) 382-2500
Entity
Organization
Contact information
Practice address
200 N PARK ST, KALAMAZOO, MI 49007-3731
(269) 384-8626
(269) 373-7478
Mailing address
200 N PARK ST, KALAMAZOO, MI 49007-3731
(269) 384-8626
(269) 373-7478
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
5301010374
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730506510
—
MI
01
—
2144774
PK
—
Enumeration date
03/18/2014
Last updated
03/01/2017
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