Healthcare Provider Details

I. General information

NPI: 1285934471
Provider Name (Legal Business Name): ALEXANDER EDWARD-TAPANI CRIBLEY PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2010
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10772 WEST CARSON CITY ROAD
GREENVILLE MI
48838
US

IV. Provider business mailing address

10772 WEST CARSON CITY ROAD
GREENVILLE MI
48838
US

V. Phone/Fax

Practice location:
  • Phone: 616-754-5203
  • Fax: 616-754-5372
Mailing address:
  • Phone: 616-754-5203
  • Fax: 616-754-5372

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302038190
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: