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NPI Code Detail

MEDICARE: WADE R KITTLE

MEDICARE: WADE R KITTLE
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
1183500000XPharmacist5302031884MI

General Provider Information

NPI Number : 1477839371
Entity Type Code : Individual
Provider Name (Legal Business Name) : WADE R KITTLE
Provider Business Mailing Address
First Line : 150 E PINEVIEW DR
Second Line :
City : SAGINAW
State : MI
Zip : 48609-9420
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 931 S SAGINAW RD
Second Line :
City : MIDLAND
State : MI
Zip : 48640-4602
Country : US
Telephone Number : 989-631-0910
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2011
Last Update Date : 10/25/2011

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Directions to “ WADE R KITTLE ” Practice Location

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