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NPI Code Detail

MEDICARE: LYNDA ANDERSON C.PH.T.

MEDICARE:   LYNDA  ANDERSON  C.PH.T.
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 Technician290101040755371MI

General Provider Information

NPI Number : 1952460222
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDA ANDERSON C.PH.T.
Provider Business Mailing Address
First Line : 1861 20 MILE RD
Second Line :
City : KENT CITY
State : MI
Zip : 49330-9735
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6 S. MAIN ST.
Second Line :
City : KENT CITY
State : MI
Zip : 49330
Country : US
Telephone Number : 616-678-5380
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/08/2007

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Directions to “ LYNDA ANDERSON C.PH.T.” Practice Location

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