Most Relevant Information
Provider Data
| NPI Number: | 1407859457 |
| Provider Name: | THOMAS A. MAGNIFICO RPH |
| Entity Type: | Individual |
| Taxonomy Code: | 183500000X |
| Specialty: | Pharmacist |
| License Number: | 5302030831 |
Most Important Dates
| Enumeration Date: | 05/23/2005 |
| Last Updated: | 04/04/2017 |
Provider Practice Location
4021 CASCADE RD SE
SUITE 50
GRAND RAPIDS
MI
495462177
Practice Location Phone/Fax
| Phone: | 6169749792 |
| Fax: | 6164643469 |
Provider Mailing Location
5455 RANGER HILLS DR SE
GRAND RAPIDS
MI
495466443
Provider Mailing Phone/Fax
| Phone: | 6164984432 |
| Fax: |