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NPI Code Detail

MEDICARE: MARY ELIZABETH DENNIS RPH

MEDICARE: MARY ELIZABETH DENNIS 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
1183500000XPharmacist5302411105MI

General Provider Information

NPI Number : 1144514241
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY ELIZABETH DENNIS RPH
Provider Business Mailing Address
First Line : 3255 OWEN RD
Second Line :
City : FENTON
State : MI
Zip : 48430-1755
Country : US
Telephone Number : 810-714-2406
Fax Number : 810-714-2406
Provider Business Practice Location Address
First Line : 3255 OWEN RD
Second Line :
City : FENTON
State : MI
Zip : 48430-1755
Country : US
Telephone Number : 810-714-2406
Fax Number : 810-714-2406
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2011
Last Update Date : 06/06/2011

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