Healthcare Provider Details

I. General information

NPI: 1174169270
Provider Name (Legal Business Name): DEBRA JOYCE LAMMERS RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/23/2019
Last Update Date: 01/18/2020
Certification Date: 01/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 WEST MAIN STREET
MILAN MI
48160
US

IV. Provider business mailing address

9847 CRANE ROAD
MILAN MI
48160
US

V. Phone/Fax

Practice location:
  • Phone: 734-439-6856
  • Fax: 734-439-6864
Mailing address:
  • Phone: 734-961-8661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number5302028900
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: