MEDICARE: CLINICAL HOSPITAL PHARMACY MANAGEMENT, P.C.

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	5301007343	MI

General Provider Information

NPI Number	:	1538150875
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLINICAL HOSPITAL PHARMACY MANAGEMENT, P.C.

Provider Business Mailing Address
First Line	:	132 W CEDAR AVE
Second Line	:
City	:	GLADWIN
State	:	MI
Zip	:	48624-2018
Country	:	US
Telephone Number	:	989-426-8608
Fax Number	:

Provider Business Practice Location Address
First Line	:	132 W CEDAR AVE
Second Line	:
City	:	GLADWIN
State	:	MI
Zip	:	48624-2018
Country	:	US
Telephone Number	:	989-426-8608
Fax Number	:

Authorized Official
Title or Position	:	PHARMACY DIRECTOR
Name	:	JAMES HERMAN HORTON II
Credential	:	RPH
Telephone Number	:	989-426-8608

Provider Enumeration Date	:	11/04/2005
Last Update Date	:	08/22/2020

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