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NPI Code Detail

MEDICARE: NATHAN LOVE PHARMD

MEDICARE: NATHAN LOVE PHARMD
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
1183500000XPharmacist5302039970MI

General Provider Information

NPI Number : 1790185015
Entity Type Code : Individual
Provider Name (Legal Business Name) : NATHAN LOVE PHARMD
Provider Business Mailing Address
First Line : 5922 POLK ST
Second Line :
City : TAYLOR
State : MI
Zip : 48180-1354
Country : US
Telephone Number : 810-772-6948
Fax Number :
Provider Business Practice Location Address
First Line : 7380 ORCHARD LAKE RD
Second Line :
City : WEST BLOOMFIELD
State : MI
Zip : 48322-3621
Country : US
Telephone Number : 248-538-8373
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/25/2014
Last Update Date : 08/25/2014

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