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Great Lakes Cancer Mgmt Specialists
Non-Pharmacy Dispensing Site in Utica, Michigan
NPI 1427155357

Great Lakes Cancer Mgmt Specialists is a Non-Pharmacy Dispensing Site based in Utica, MI. Great Lakes Cancer Mgmt Specialists practices in Utica, MI. The NPI Number for Great Lakes Cancer Mgmt Specialists is 1427155357 and holds a License No. 4301056352 (Michigan).

The current practice location address for Great Lakes Cancer Mgmt Specialists is 11051 Hall Rd, Utica, MI and can be reached out via phone at 586-991-0700 and via fax at 586-991-0701.

Location: 11051 Hall Rd, Utica, MI, 48317-5735
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1427155357
Provider Name
Great Lakes Cancer Mgmt Specialists
Credential
Provider Entity Type
Organization
Address
11051 Hall Rd, Utica, MI, 48317-5735
Phone Number
586-991-0700
Fax Number
586-991-0701
Provider Enumeration Date
09/20/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
4231200 05 MI
2367159 01 OTHER ID NUMBER-COMMERCIAL NUMBER
institution
Provider Business Practice Location Address Details
Address
11051 Hall Rd
City
Utica
State
Michigan
Zip
48317-5735
Phone Number
586-991-0700
Fax Number
586-991-0701
person
Provider Business Mailing Address Details
Address
11051 Hall Rd
City
Utica
State
Michigan
Zip
48317-5735
Phone Number
586-991-0700
Fax Number
586-991-0701
person
Provider's Taxonomy Details 1
Type
Suppliers
Classification
Non-Pharmacy Dispensing Site
Speciality
-
Taxonomy
332900000X
License No.
4301056352 (Michigan)
Definition
A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.)
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