Bethany Kozielski, RPH

Individual provider Active NPI Pharmacist · Essexville, MI

NPI 1013027358 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1013027358
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
5302029866 (MI)
Practice address
1454 W Center Rd
Suite 2
Essexville, MI 48732-2112
Phone
(989) 895-4580
Fax
(989) 895-4581
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
5302029866MIMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302029866 MI Yes

Addresses

Primary practice location

1454 W Center Rd
Suite 2
Essexville, MI 48732-2112

Mailing address

1036 Hampstead Rd
Essexville, MI 48732-1908
Phone (989) 895-8947

Other providers in Essexville, MI

All providers in Essexville, MI · Pharmacist in Michigan

Sources for this page

Verify at the official NPI Registry.