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NPI Code Detail

MEDICARE: KAREN LOUISE MAC RPH.

MEDICARE: KAREN LOUISE MAC RPH.
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
1183500000XPharmacist5302027867MI

General Provider Information

NPI Number : 1043593361
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAREN LOUISE MAC RPH.
Provider Business Mailing Address
First Line : 5505 S OLD US 23
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-7524
Country : US
Telephone Number : 810-229-5466
Fax Number : 810-229-5593
Provider Business Practice Location Address
First Line : 5505 S OLD US 23
Second Line :
City : BRIGHTON
State : MI
Zip : 48116-7524
Country : US
Telephone Number : 810-229-5466
Fax Number : 810-229-5593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2011
Last Update Date : 09/22/2011

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Directions to “ KAREN LOUISE MAC RPH.” Practice Location

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