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General NPI Number Information
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NPI Number | 1013518059
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Entity Type | Individual
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Provider Name | DOLORES F MAYVILLE RPH
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Gender | Female
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Dates
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Enumeration Date | 11/05/2020
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Last Update Date | 11/05/2020
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Provider Practice Location Address
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Address Line | 2750 COOK RD
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City | WEST BRANCH
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State | MI
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Zip | 48661-8744
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Country | US
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Telephone | 989-343-9761
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Fax |
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Provider Business Mailing Address
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Address Line | 9210 RHODE ISLAND CIR
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City | OSCODA
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State | MI
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Zip | 48750-1900
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Country | US
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Telephone | 989-254-9426
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Fax |
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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 | 5302034781
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License Number State | MI
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