MEDICARE: MR. MICHAEL E STINNETT 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
1	183500000X	Pharmacist	011957	KY

General Provider Information

NPI Number	:	1376752220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL E STINNETT RPH

Provider Business Mailing Address
First Line	:	PO BOX 1884
Second Line	:
City	:	BOWLING GREEN
State	:	KY
Zip	:	42102-1884
Country	:	US
Telephone Number	:	270-392-4248
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 S BROADWAY ST
Second Line	:
City	:	PORTLAND
State	:	TN
Zip	:	37148-1628
Country	:	US
Telephone Number	:	270-842-4515
Fax Number	:	270-901-0187

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	01/05/2022

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