Healthcare Provider Details

I. General information

NPI: 1912441668
Provider Name (Legal Business Name): LINDA KAY TOWN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2016
Last Update Date: 12/15/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 COVERED VLG
BELDING MI
48809-1683
US

IV. Provider business mailing address

100 COVERED VLG
BELDING MI
48809-1683
US

V. Phone/Fax

Practice location:
  • Phone: 616-794-2200
  • Fax:
Mailing address:
  • Phone: 231-499-9109
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302041567
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: