Healthcare Provider Details

I. General information

NPI: 1164604617
Provider Name (Legal Business Name): RICHARD LEE FILA RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/27/2007
Last Update Date: 11/27/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

514 MAIN ST
NORWAY MI
49870-1238
US

IV. Provider business mailing address

514 MAIN ST
NORWAY MI
49870-1238
US

V. Phone/Fax

Practice location:
  • Phone: 906-563-5151
  • Fax: 906-563-5978
Mailing address:
  • Phone: 906-563-5151
  • Fax: 906-563-5978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302024687
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: