Healthcare Provider Details

I. General information

NPI: 1699988857
Provider Name (Legal Business Name): CATHERINE ANN CARMODY RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 05/09/2026
Certification Date: 05/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4884 MARSH RD
OKEMOS MI
48864-1123
US

IV. Provider business mailing address

4884 MARSH RD
OKEMOS MI
48864-1123
US

V. Phone/Fax

Practice location:
  • Phone: 517-347-0102
  • Fax: 517-347-0108
Mailing address:
  • Phone: 517-347-0102
  • Fax: 517-347-0108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302029793
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: