Healthcare Provider Details

I. General information

NPI: 1063822534
Provider Name (Legal Business Name): DIANE LYNETTE GARBE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2014
Last Update Date: 05/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3360 TITTABAWASSEE RD
SAGINAW MI
48604-9453
US

IV. Provider business mailing address

744 E SEIDLERS RD
KAWKAWLIN MI
48631-9742
US

V. Phone/Fax

Practice location:
  • Phone: 989-249-6033
  • Fax: 989-249-6065
Mailing address:
  • Phone: 989-684-6341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number5302026026
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: