Provider Demographics
NPI:1952322919
Name:CONTINUHEALTH
Entity Type:Organization
Organization Name:CONTINUHEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP OPS AND GEN COUNSEL
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:INMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:616-874-4889
Mailing Address - Street 1:2556 VAN OMMEN DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2556 VAN OMMEN DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-8208
Practice Address - Country:US
Practice Address - Phone:616-399-5511
Practice Address - Fax:616-738-5350
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5301008353333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2363036OtherOTHER ID NUMBER-COMMERCIAL NUMBER