Healthcare Provider Details

I. General information

NPI: 1619172343
Provider Name (Legal Business Name): CYNTHIA LYNN FEUCHT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 OAKLAND DR
KALAMAZOO MI
49008-1282
US

IV. Provider business mailing address

4513 FOREST CREEK DR
KALAMAZOO MI
49009-9604
US

V. Phone/Fax

Practice location:
  • Phone: 269-337-6480
  • Fax:
Mailing address:
  • Phone: 269-544-0285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302035489
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: