Provider Demographics
NPI:1295844066
Name:ROOS, CHRISTOPHER GERARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:GERARD
Last Name:ROOS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:42695 WIMBLETON WAY
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48377-2044
Mailing Address - Country:US
Mailing Address - Phone:248-926-8696
Mailing Address - Fax:248-926-8746
Practice Address - Street 1:1700 JUNCTION ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48209-2110
Practice Address - Country:US
Practice Address - Phone:313-843-8770
Practice Address - Fax:313-843-8775
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5302026095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist