1366433575 NPI number — CLINICAL HOSPITAL PHARMACY MANAGEMENT, P.C.

Table of content: KELLY NADLER STEFFAN DO (NPI 1497457667)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366433575 NPI number — CLINICAL HOSPITAL PHARMACY MANAGEMENT, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CLINICAL HOSPITAL PHARMACY MANAGEMENT, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366433575
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 519
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FREELAND
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48623-0519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
989-695-6500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7620 MIDLAND RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FREELAND
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48623-8705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
989-695-6500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/04/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HORTON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
HERMAN
Authorized Official Title or Position:
PHARMACY DIRECTOR
Authorized Official Telephone Number:
989-695-6500

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  5301007570 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com