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NPI 1598134330

NPI 1598134330 : CRAIG THOMAS LEE PHARMD, R.PH. : HILLSDALE, MI

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General NPI Number Information
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    NPI Number           |    1598134330
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    Entity Type          |    Individual 
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    Provider Name        |    CRAIG THOMAS LEE PHARMD, R.PH.
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    09/23/2015
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    Last Update Date     |    09/23/2015
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Provider Practice Location Address
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    Address Line         |    30 N HOWELL ST 
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    City                 |    HILLSDALE
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    State                |    MI
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    Zip                  |    49242-1621
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    Country              |    US
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    Telephone            |    517-437-4497
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    30 N HOWELL ST 
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    City                 |    HILLSDALE
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    State                |    MI
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    Zip                  |    49242-1621
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    Country              |    US
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    Telephone            |    517-437-4497
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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       |    5302034000
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    License Number State |    MI
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