Provider Demographics
NPI:1235751306
Name:YPSILANTI FAMILY PHARMACY, INC.
Entity Type:Organization
Organization Name:YPSILANTI FAMILY PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADM
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHEINOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-434-2448
Mailing Address - Street 1:2287 ELLSWORTH RD STE A
Mailing Address - Street 2:
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-4805
Mailing Address - Country:US
Mailing Address - Phone:734-434-2448
Mailing Address - Fax:734-434-2458
Practice Address - Street 1:2287 ELLSWORTH RD STE A
Practice Address - Street 2:
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-4805
Practice Address - Country:US
Practice Address - Phone:734-434-2448
Practice Address - Fax:734-434-2458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-12
Last Update Date:2020-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1659615441Medicaid