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NPI Code Detail

MEDICARE: MICHELLE BERENICE MOSKOVICH RPH

MEDICARE: MICHELLE BERENICE MOSKOVICH 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
1183500000XPharmacist051305010IL

General Provider Information

NPI Number : 1952028219
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE BERENICE MOSKOVICH RPH
Provider Business Mailing Address
First Line : 112 SHOREWOOD DR
Second Line :
City : VALPARAISO
State : IN
Zip : 46385-8064
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2828 N HARLEM AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-1637
Country : US
Telephone Number : 219-805-0035
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2022
Last Update Date : 10/26/2022

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Directions to “ MICHELLE BERENICE MOSKOVICH RPH” Practice Location

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