Provider Demographics
NPI:1609488998
Name:JOHNSON, ANDREW WINSTON (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:WINSTON
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:MI
Mailing Address - Zip Code:48801-1018
Mailing Address - Country:US
Mailing Address - Phone:989-463-2704
Mailing Address - Fax:989-463-8596
Practice Address - Street 1:1420 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1018
Practice Address - Country:US
Practice Address - Phone:989-463-2704
Practice Address - Fax:989-463-8596
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302045236183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist