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General NPI Number Information
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NPI Number | 1013193002
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Entity Type | Individual
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Provider Name | DAVID HARTTER R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/21/2008
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 159 KERCHEVAL AVE PHARMACY
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City | GROSSE POINTE FARMS
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State | MI
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Zip | 48236-3610
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Country | US
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Telephone | 313-640-2482
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Fax | 313-343-8657
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Provider Business Mailing Address
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Address Line | 5450 FORT ST PHARMACY
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City | TRENTON
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State | MI
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Zip | 48183-4601
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Country | US
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Telephone | 734-671-3839
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Fax | 734-642-2070
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302023164
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License Number State | MI
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