Kevin Walsh
Individual provider Active NPI Pharmacist · Davison, MI
NPI 1285058883 · NPPES record last updated Jan 26, 2016
Key facts
- NPI
- 1285058883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302038011 (MI)
- Practice address
- 901 S State Rd
Davison, MI 48423-1721 - Phone
- (810) 653-4020
- NPI assigned
- Feb 18, 2014
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302038011 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Davison Pharmacy LLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302038011 | MI | Yes |
Addresses
Primary practice location
901 S State Rd
Davison, MI 48423-1721
Mailing address
901 S State Rd
Davison, MI 48423-1721
Phone (810) 653-4020
Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 26, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.