Provider Demographics
NPI:1447023999
Name:MSU HEALTH CARE INC
Entity type:Organization
Organization Name:MSU HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER ENROLLMENT MANGER
Authorized Official - Prefix:
Authorized Official - First Name:RELANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRICE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:517-884-2976
Mailing Address - Street 1:4660 S HAGADORN RD STE 100
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-5353
Mailing Address - Country:US
Mailing Address - Phone:517-353-3776
Mailing Address - Fax:517-353-3510
Practice Address - Street 1:4660 S HAGADORN RD STE 100
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-5353
Practice Address - Country:US
Practice Address - Phone:517-353-3776
Practice Address - Fax:517-353-3510
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MSU HEALTH CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-11-06
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy