MEDICARE: ALLISON RENEE GIFFIN PHARM.D.

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	5302033716	MI

General Provider Information

NPI Number	:	1710273461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLISON RENEE GIFFIN PHARM.D.

Provider Business Mailing Address
First Line	:	47330 MICHIGAN AVE
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-2582
Country	:	US
Telephone Number	:	734-714-2013
Fax Number	:	734-714-2115

Provider Business Practice Location Address
First Line	:	47330 MICHIGAN AVE
Second Line	:
City	:	CANTON
State	:	MI
Zip	:	48188-2582
Country	:	US
Telephone Number	:	734-714-2013
Fax Number	:	734-714-2115

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

Provider Enumeration Date	:	06/21/2011
Last Update Date	:	06/21/2011

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