Healthcare Provider Details

I. General information

NPI: 1447565387
Provider Name (Legal Business Name): DEBORAH LYNN CAUGHEL RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2010
Last Update Date: 08/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

66711 GRATIOT AVE
RICHMOND MI
48062-1909
US

IV. Provider business mailing address

66711 GRATIOT AVE
RICHMOND MI
48062-1909
US

V. Phone/Fax

Practice location:
  • Phone: 586-727-9715
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302410780
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: