Shane Bentley, PHARMACY TECHNICIAN

Individual provider Active NPI Pharmacy Technician · Houghton Lake, MI

NPI 1215601331 · NPPES record last updated Aug 3, 2021

Key facts

NPI
1215601331
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacy Technician 183700000X
License
5303022152 (MI)
Practice address
4562 W Houghton Lake Dr
Houghton Lake, MI 48629-9005
Phone
(989) 366-9212
Fax
(989) 366-4776
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5303022152MIMDPharmacy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Apex Drug Stores Inc Past
since Aug 8, 2021
Accepting new patients
Apex Drug Stores Inc Past
since Aug 8, 2021
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy Technician 183700000X 5303022152 MI Yes

Addresses

Primary practice location

4562 W Houghton Lake Dr
Houghton Lake, MI 48629-9005

Mailing address

4562 W Houghton Lake Dr
Houghton Lake, MI 48629-9005
Phone (989) 366-9212

Other providers in Houghton Lake, MI

All providers in Houghton Lake, MI · Pharmacy Technician in Michigan

Sources for this page

Verify at the official NPI Registry.