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NPI Code Detail

MEDICARE: NICOLE LAM RPH

MEDICARE: NICOLE LAM 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
1183500000XPharmacist5302028780MI

General Provider Information

NPI Number : 1669830089
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE LAM RPH
Provider Business Mailing Address
First Line : 4326 28TH ST SE
Second Line :
City : KENTWOOD
State : MI
Zip : 49512-1908
Country : US
Telephone Number : 616-285-3346
Fax Number : 616-285-7631
Provider Business Practice Location Address
First Line : 4326 28TH ST SE
Second Line :
City : KENTWOOD
State : MI
Zip : 49512-1908
Country : US
Telephone Number : 616-285-3346
Fax Number : 616-285-7631
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2016
Last Update Date : 01/29/2016

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Directions to “ NICOLE LAM RPH” Practice Location

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