Provider Demographics
NPI:1972237709
Name:VANHEEST, LUCAS (PHARMD)
Entity Type:Individual
Prefix:
First Name:LUCAS
Middle Name:
Last Name:VANHEEST
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 1:3861 E LANGOUR LN APT 109
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8278
Mailing Address - Country:US
Mailing Address - Phone:616-218-1652
Mailing Address - Fax:
Practice Address - Street 1:3320 W SHORE DR
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424-7753
Practice Address - Country:US
Practice Address - Phone:616-994-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-16
Last Update Date:2022-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413817183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist