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NPI Code Detail

MEDICARE: DR. MICHAEL W. KITCHEN PHARMD

MEDICARE: DR. MICHAEL W. KITCHEN PHARMD
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
1183500000XPharmacist43124TX

General Provider Information

NPI Number : 1679887012
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL W. KITCHEN PHARMD
Provider Business Mailing Address
First Line : 420 N FRAZIER ST
Second Line :
City : CONROE
State : TX
Zip : 77301-2882
Country : US
Telephone Number : 936-494-0424
Fax Number : 936-494-0431
Provider Business Practice Location Address
First Line : 420 N FRAZIER ST
Second Line :
City : CONROE
State : TX
Zip : 77301-2882
Country : US
Telephone Number : 936-494-0424
Fax Number : 936-494-0431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2010
Last Update Date : 07/27/2010

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