MEDICARE: MRS. LORRAINE ROSE WEINENGER 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	183500000X	Pharmacist	5302024107	MI

General Provider Information

NPI Number	:	1427261494
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LORRAINE ROSE WEINENGER RPH

Provider Business Mailing Address
First Line	:	32305 MIDDLEBELT RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48334-1718
Country	:	US
Telephone Number	:	248-486-0720
Fax Number	:	248-486-3920

Provider Business Practice Location Address
First Line	:	56270 GRAND RIVER AVE
Second Line	:
City	:	NEW HUDSON
State	:	MI
Zip	:	48165-9727
Country	:	US
Telephone Number	:	248-486-0720
Fax Number	:	248-486-3920

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

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	07/08/2007

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