MEDICARE: MR. DUANE L CHAPPUIES

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	5302022452	MI

General Provider Information

NPI Number	:	1548400815
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DUANE L CHAPPUIES

Provider Business Mailing Address
First Line	:	1681 W OLD STATE RD
Second Line	:	P.O. BOX 359
City	:	EAST JORDAN
State	:	MI
Zip	:	49727-8860
Country	:	US
Telephone Number	:	231-536-7657
Fax Number	:	231-544-5408

Provider Business Practice Location Address
First Line	:	2424 N MAIN ST
Second Line	:
City	:	CENTRAL LAKE
State	:	MI
Zip	:	49622-9271
Country	:	US
Telephone Number	:	231-544-2929
Fax Number	:	231-544-5408

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

Provider Enumeration Date	:	02/26/2009
Last Update Date	:	02/26/2009

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