Healthcare Provider Details

I. General information

NPI: 1184826166
Provider Name (Legal Business Name): RITA O COLEMAN RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 E 8 MILE RD
DETROIT MI
48234-1008
US

IV. Provider business mailing address

1584 STIRLING LAKES DR
PONTIAC MI
48340-1373
US

V. Phone/Fax

Practice location:
  • Phone: 313-892-4600
  • Fax: 313-892-3753
Mailing address:
  • Phone: 313-587-2398
  • Fax: 248-475-0971

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302031675
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: