Healthcare Provider Details

I. General information

NPI: 1417368945
Provider Name (Legal Business Name): MICHAEL QUIGLEY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2014
Last Update Date: 05/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 E ALEXIS RD
TOLEDO OH
43612-3952
US

IV. Provider business mailing address

1500 E ALEXIS RD
TOLEDO OH
43612-3952
US

V. Phone/Fax

Practice location:
  • Phone: 419-727-2020
  • Fax: 419-727-2065
Mailing address:
  • Phone: 419-727-2020
  • Fax: 419-727-2065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03320972
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: