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NPI Code Detail

MEDICARE: MR. JOHN RICHARD BATEK III RPH

MEDICARE: MR. JOHN RICHARD BATEK III 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
1183500000XPharmacist5302024132MI

General Provider Information

NPI Number : 1164718854
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN RICHARD BATEK III RPH
Provider Business Mailing Address
First Line : 5350 W MAIN ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-3304
Country : US
Telephone Number : 269-349-6290
Fax Number : 269-349-6290
Provider Business Practice Location Address
First Line : 5350 W MAIN ST
Second Line :
City : KALAMAZOO
State : MI
Zip : 49009-3304
Country : US
Telephone Number : 269-349-6290
Fax Number : 269-349-6290
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2011
Last Update Date : 06/22/2011

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