Healthcare Provider Details

I. General information

NPI: 1407266356
Provider Name (Legal Business Name): MARTIN STEINKE B.S.PHARM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2014
Last Update Date: 04/30/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6660 W MAIN ST
KALAMAZOO MI
49009-3962
US

IV. Provider business mailing address

6660 W MAIN ST
KALAMAZOO MI
49009-3962
US

V. Phone/Fax

Practice location:
  • Phone: 269-372-9133
  • Fax: 269-372-9165
Mailing address:
  • Phone: 269-372-9133
  • Fax: 269-372-9165

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302024471
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: