Healthcare Provider Details

I. General information

NPI: 1346663341
Provider Name (Legal Business Name): DEBRA SINGER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2014
Last Update Date: 01/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5150 FRANKLIN ST
MICHIGAN CITY IN
46360-7878
US

IV. Provider business mailing address

1306 W WATER ST
NEW BUFFALO MI
49117-1051
US

V. Phone/Fax

Practice location:
  • Phone: 219-877-2410
  • Fax: 219-877-2465
Mailing address:
  • Phone: 269-231-5533
  • Fax: 219-877-2465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302022077
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number26023467A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: