MEDICARE: KELBEL PHARMACY INC.

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	333600000X	Pharmacy	6380	MI
2	3336C0003X	Community/Retail Pharmacy	5301006380	MI

General Provider Information

NPI Number	:	1710095831
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KELBEL PHARMACY INC.

Provider Business Mailing Address
First Line	:	205 E MAIN ST
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-1511
Country	:	US
Telephone Number	:	231-526-5971
Fax Number	:	231-526-0376

Provider Business Practice Location Address
First Line	:	205 E MAIN ST
Second Line	:
City	:	HARBOR SPRINGS
State	:	MI
Zip	:	49740-1511
Country	:	US
Telephone Number	:	231-526-5971
Fax Number	:	231-526-0376

Authorized Official
Title or Position	:	OWNER/MANAGER
Name	:	MS. LEANNE KELBEL
Credential	:
Telephone Number	:	231-526-5971

Provider Enumeration Date	:	08/28/2006
Last Update Date	:	11/09/2016

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Directions to “KELBEL PHARMACY INC. ” Practice Location

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