MEDICARE: JAMES KELBEL JR.

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	183500000X	Pharmacist	5302027951	MI

General Provider Information

NPI Number	:	1417421835
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES KELBEL JR.

Provider Business Mailing Address
First Line	:	205 E MAIN ST
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-1511
Country	:	US
Telephone Number	:	231-526-5971
Fax Number	:	231-526-0376

Provider Business Practice Location Address
First Line	:	205 E MAIN ST
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-1511
Country	:	US
Telephone Number	:	231-526-5971
Fax Number	:	231-526-0376

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

Provider Enumeration Date	:	01/18/2019
Last Update Date	:	01/18/2019

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