Provider Demographics
NPI:1033385851
Name:REGENTS OF THE UNIVERSITY OF MICHIGAN AMBULATORY PHARMACY
Entity Type:Organization
Organization Name:REGENTS OF THE UNIVERSITY OF MICHIGAN AMBULATORY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:STEVENSON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:734-647-7794
Mailing Address - Street 1:1500 E MEDICAL CENTER DR
Mailing Address - Street 2:UMH PHARMACY SERVICES-UHB2D301
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-5000
Mailing Address - Country:US
Mailing Address - Phone:734-764-3150
Mailing Address - Fax:734-763-0306
Practice Address - Street 1:1500 E MEDICAL CENTER DR
Practice Address - Street 2:UMH AMBULATORY PHARMACY SERVICES
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-5000
Practice Address - Country:US
Practice Address - Phone:734-764-3150
Practice Address - Fax:734-764-0306
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-01
Last Update Date:2008-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4820580001Medicare NSC