1356013676 NPI number — MORGAN R COLE PHARMD

Table of content: MORGAN R COLE PHARMD (NPI 1356013676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356013676 NPI number — MORGAN R COLE PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLE
Provider First Name:
MORGAN
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1356013676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
426 MICHIGAN ST. NE
Provider Second Line Business Mailing Address:
MAIL CODE 9001
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-486-0646
Provider Business Mailing Address Fax Number:
616-459-1909

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
426 MICHIGAN ST. NE
Provider Second Line Business Practice Location Address:
MAIL CODE 9001
Provider Business Practice Location Address City Name:
GRAND RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-267-8338
Provider Business Practice Location Address Fax Number:
616-459-1909
Provider Enumeration Date:
10/05/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1835P2201X , with the licence number:  5302036332 , 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)

  • Identifier: 5302036332 . This is a "STATE OF MICHIGAN PHARMACIST" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".




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