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NPI Code Detail

MEDICARE: DR. MICHAEL ADAM GRIMES PHARM.D., R.PH.

MEDICARE: DR. MICHAEL ADAM GRIMES PHARM.D., R.PH.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRP441069PA

General Provider Information

NPI Number : 1043382286
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ADAM GRIMES PHARM.D., R.PH.
Provider Business Mailing Address
First Line : 35 HIGHLAND RD
Second Line : APT 6115
City : BETHEL PARK
State : PA
Zip : 15102-1865
Country : US
Telephone Number : 304-288-4567
Fax Number : 412-572-3495
Provider Business Practice Location Address
First Line : 3210 BANKSVILLE RD
Second Line :
City : PITTSBURGH
State : PA
Zip : 15216-2757
Country : US
Telephone Number : 412-388-1601
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/14/2006
Last Update Date : 07/08/2007

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