MEDICARE: MRS. DEBORAH WEIR RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	5302029524	MI

General Provider Information

NPI Number	:	1336559962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DEBORAH WEIR RPH

Provider Business Mailing Address
First Line	:	54450 BLACK CHERRY LN
Second Line	:
City	:	SHELBY TWP
State	:	MI
Zip	:	48315-1460
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8401 26 MILE RD
Second Line	:
City	:	WASHINGTON TWP
State	:	MI
Zip	:	48094-2964
Country	:	US
Telephone Number	:	586-677-8010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/05/2014
Last Update Date	:	05/05/2014

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