Individual provider Active NPI

Robertson G Zuah, RPH

  • Pharmacist
  • Grand Rapids, MI
National Provider Identifier
1992172712
Registry record updated Aug 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
5302029530 Issued in MI
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

Updated by the provider on Aug 27, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
5302029530OtherMIPHARMACIST 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

LicenseStateTypeSpecialty
5302029530MIMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Zuah Pharmacy Wellness Clinic LLC CurrentSince Oct 13, 2024 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.

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.

Verify at the official NPI Registry.