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General NPI Number Information
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NPI Number | 1144226689
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Entity Type | Individual
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Provider Name | MARYBETH AVRIPAS MARSHALL R.PH.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 10/26/2007
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Provider Practice Location Address
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Address Line | 44405 WOODWARD AVE # H-13
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City | PONTIAC
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State | MI
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Zip | 48341-5023
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Country | US
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Telephone | 248-858-3787
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Fax | 248-858-3794
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Provider Business Mailing Address
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Address Line | 43 OLDBROOK LN
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City | GROSSE POINTE
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State | MI
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Zip | 48236-3010
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Country | US
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Telephone | 248-858-3787
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Fax | 248-858-3794
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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 | 5302029009
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License Number State | MI
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