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NPI Code Detail

MEDICARE: KIM VU WHITFORD R,PH

MEDICARE: KIM VU WHITFORD R,PH
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
1183500000XPharmacist5302029978MI

General Provider Information

NPI Number : 1407021827
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIM VU WHITFORD R,PH
Provider Business Mailing Address
First Line : 4776 SUNDIAL DR NE
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49525-9449
Country : US
Telephone Number : 616-745-9782
Fax Number :
Provider Business Practice Location Address
First Line : 511 E DIVISION ST
Second Line :
City : ROCKFORD
State : MI
Zip : 49341-1376
Country : US
Telephone Number : 616-745-9782
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/26/2008
Last Update Date : 04/26/2008

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Directions to “ KIM VU WHITFORD R,PH” Practice Location

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