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General NPI Number Information
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NPI Number | 1194474890
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Entity Type | Individual
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Provider Name | ARJOL KOKA PHARMD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 03/21/2022
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Provider Practice Location Address
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Address Line | 3681 SHAWNEE RD
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City | BRIDGMAN
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State | MI
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Zip | 49106-9713
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Country | US
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Telephone | 269-465-6777
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Fax |
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Provider Business Mailing Address
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Address Line | 907 MINNESOTA DR APT 1
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City | TROY
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State | MI
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Zip | 48083-4439
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Country | US
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Telephone | 248-808-7764
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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 | 5302413137
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License Number State | MI
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