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NPI Code Detail

MEDICARE: MRS. SUSAN JEAN HERRMANN CPHT

MEDICARE: MRS. SUSAN JEAN HERRMANN CPHT
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
1183700000XPharmacy Technician170102773514872MI

General Provider Information

NPI Number : 1881819746
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SUSAN JEAN HERRMANN CPHT
Provider Business Mailing Address
First Line : 20472 COLUMBIA DR
Second Line :
City : MACOMB
State : MI
Zip : 48044-5755
Country : US
Telephone Number : 586-263-9504
Fax Number :
Provider Business Practice Location Address
First Line : 3500 15 MILE RD
Second Line :
City : STERLING HEIGHTS
State : MI
Zip : 48310-5353
Country : US
Telephone Number : 586-977-9971
Fax Number : 586-977-6231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/16/2007
Last Update Date : 07/08/2007

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