Stacey Butch, PHARMD
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Fremont, MI
NPI 1487178786 · NPPES record last updated May 22, 2024
Key facts
- NPI
- 1487178786
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- 5302414596 (MI)
- Practice address
- 230 W Oak St
Fremont, MI 49412-1526 - Phone
- (231) 924-4200
- Fax
- (616) 267-9046
- NPI assigned
- Jul 28, 2017
- 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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302414596 | MI | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | 5302414596 | MI | Yes |
| Pharmacist | 183500000X | 27224 | NC |
Addresses
Primary practice location
230 W Oak St
Fremont, MI 49412-1526
Mailing address
27 W Wood St
Newaygo, MI 49337-8992
Phone (458) 226-9044
Other names
- Stacey Marie Sprague
Other providers in Fremont, MI
- Richard S. Boss
- Jennifer M Boyd
- Rebecca Joy Bruins
- Lisa G Brummel
- Tianna Lynn Burns
- Koby J Buth
- Jeffrey B Byland
- C & C Optical Shop Inc.
- Michael Peter Campeau
- John William Carlson Jr.
All providers in Fremont, MI · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 22, 2024. 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.