Doctor Name: | DR. AMY S POUILLON |
NPI Number: | 1326256413 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHARMD |
License Number: | 5302034728 |
Business Practice Address: | 938 Maxwell Ave Se East Grand Rapids, MI - 495063443 |
Business Phone Number: | 6167069210 |
Business Fax Number: | 8666185691 |
Mailing Address: | 938 Maxwell Ave Se, EAST GRAND RAPIDS |
State: | MI |
Postal Code: | 495063443 |
Phone Number: | 6167069210 |
Fax Number: | 8666185691 |
NPI Enumeration Date: | 05/20/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1835G0303X |
License Number: | 5302034728 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
Taxonomy Type: | Pharmacy Service Providers |
Taxonomy Classification: | Pharmacist |
Taxonomy Specialization: | Geriatric |
Taxonomy Definition: | A pharmacist who is certified in geriatric pharmacy practice is designated as a |