Robert Koehl
Individual provider Active NPI Pharmacist · Bath, MI
NPI 1427487230 · NPPES record last updated Nov 2, 2013
Key facts
- NPI
- 1427487230
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302026126 (MI)
- Practice address
- 4364 Sleight Rd
Bath, MI 48808-8404 - Phone
- (517) 643-3464
- NPI assigned
- Nov 2, 2013
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302026126 | MI | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302026126 | MI | Yes |
Addresses
Primary practice location
4364 Sleight Rd
Bath, MI 48808-8404
Mailing address
4364 Sleight Rd
Bath, MI 48808-8404
Phone (517) 643-3464
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5302026126 | Other | MI | PHARMACY |
Other providers in Bath, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2013. 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.