GPS OF MICHIGAN INSTITUTIONAL; NPI #1457387185

Contact Information

GPS OF MICHIGAN INSTITUTIONAL

1201 KEYSTONE AVE
STE A
LANSING, MI 48911-4041

Phone: 517-882-5515
Fax: 517-882-6313
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Long Term Care Pharmacy	3336L0003X	58	Medical Supply Company with Pharmacist
Institutional Pharmacy	3336I0012X	58	Medical Supply Company with Pharmacist

Indicates primary specialty

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NPI Profile & details for GPS OF MICHIGAN INSTITUTIONAL

NPI Number 1457387185

LBN Legal business name GPS OF MICHIGAN INSTITUTIONAL

Authorized official FRED GHANNAM - (CEO OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 06/24/2006

Last updated 09/01/2009 - About 17 years ago

Identifiers

MI	License #	5301007720
MI	Medicaid	0097325145
MI	Medicaid	2364937
	Other	2364937	NCPDP PROVIDER IDENTIFICATION NUMBER

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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