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NPI Code Detail

MEDICARE: DR. MICHAEL KENNEDY PHARMD

MEDICARE: DR. MICHAEL KENNEDY PHARMD
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
1183500000XPharmacist5302035766MI

General Provider Information

NPI Number : 1316578032
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL KENNEDY PHARMD
Provider Business Mailing Address
First Line : 3010 WALTON BLVD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-1264
Country : US
Telephone Number : 248-375-2810
Fax Number :
Provider Business Practice Location Address
First Line : 3010 WALTON BLVD
Second Line :
City : ROCHESTER HILLS
State : MI
Zip : 48309-1264
Country : US
Telephone Number : 248-375-2810
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2020
Last Update Date : 01/31/2020

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