Healthcare Provider Details

I. General information

NPI: 1427261494
Provider Name (Legal Business Name): LORRAINE ROSE WEINENGER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56270 GRAND RIVER AVE
NEW HUDSON MI
48165-9727
US

IV. Provider business mailing address

32305 MIDDLEBELT RD
FARMINGTON HILLS MI
48334-1718
US

V. Phone/Fax

Practice location:
  • Phone: 248-486-0720
  • Fax: 248-486-3920
Mailing address:
  • Phone: 248-486-0720
  • Fax: 248-486-3920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302024107
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: