Active NPI
Robertson G Zuah, RPH
- Pharmacist
- Grand Rapids, MI
National Provider Identifier
1992172712
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 5302029530
- Practice address
- 4301 Kalamazoo Ave SE Ste 13
Grand Rapids, MI 49508-3673 - Phone
- (616) 438-3474
- NPI assigned
- Aug 27, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302029530 | MI | Primary |
Addresses
Primary practice location
4301 Kalamazoo Ave SE Ste 13
Grand Rapids, MI 49508-3673
Mailing address
5768 Sugarberry Dr SE
Kentwood, MI 49512-9413
Phone (616) 438-3474
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302029530 | Other | MI | PHARMACIST LISENCE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302029530 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zuah Pharmacy Wellness Clinic LLC | Current | Accepting new patients | |
| Zuah Pharmacy , LLC | Past | Accepting new patients |
Locations
4301 Kalamazoo Ave SE
Ste 13
Grand Rapids, MI 49508
Phone (616) 259-9314
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinic Pharmacy
- Grand Rapids, MI
- NPI 1427877364
-
- Community/Retail Pharmacy
- Grand Rapids, MI
- NPI 1477909869
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1440633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1440633600000",
"number": "1992172712",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5768 SUGARBERRY DR SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495129413",
"telephone_number": "616-438-3474"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 KALAMAZOO AVE SE STE 13",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495083673",
"telephone_number": "616-438-3474"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ZUAH",
"first_name": "ROBERTSON",
"middle_name": "G",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-08-27",
"last_updated": "2015-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MI",
"license": "5302029530",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LISENCE",
"identifier": "5302029530",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.