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NPI Code Detail

MEDICARE: MRS. KATHLEEN MARIE JANUS RPH

MEDICARE: MRS. KATHLEEN MARIE JANUS 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
1183500000XPharmacist5302029536MI

General Provider Information

NPI Number : 1811059769
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KATHLEEN MARIE JANUS RPH
Provider Business Mailing Address
First Line : 57730 DEERE CT
Second Line :
City : SOUTH LYON
State : MI
Zip : 48178-8617
Country : US
Telephone Number : 734-751-6265
Fax Number :
Provider Business Practice Location Address
First Line : 39350 9 MILE RD
Second Line :
City : NORTHVILLE
State : MI
Zip : 48167-9164
Country : US
Telephone Number : 248-735-6081
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2006
Last Update Date : 02/04/2020

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