Charles Mantey, RPH

Individual provider Active NPI Pharmacotherapy Pharmacist · Port Austin, MI

NPI 1427265404 · NPPES record last updated Sep 11, 2025

Key facts

NPI
1427265404
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacotherapy Pharmacist 1835P1200X
License
5302023331 (MI)
Practice address
8827 Liberty St.
Port Austin, MI 48467
Phone
(989) 269-9024
Fax
(989) 453-4465
NPI assigned
May 17, 2007
Sex
Male
Sole proprietor
Yes

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
5302023331MIMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 5302023331 MI
Pharmacotherapy Pharmacist 1835P1200X 5302023331 MI Yes

Addresses

Primary practice location

8827 Liberty St.
Port Austin, MI 48467

Mailing address

8827 Liberty St.
Port Austin, MI 48467
Phone (989) 269-9024

Other providers in Port Austin, MI

All providers in Port Austin, MI · Pharmacotherapy Pharmacist in Michigan

Sources for this page

Verify at the official NPI Registry.