Martha Ann Fisher, RPH
Individual provider Active NPI Pharmacist · Kimball, MI
NPI 1487285342 · NPPES record last updated Jan 30, 2020
Key facts
- NPI
- 1487285342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302024818 (MI)
- Practice address
- 4514 Gratiot Rd
Kimball, MI 48074-4508 - Phone
- (810) 364-6980
- Fax
- (810) 364-1883
- NPI assigned
- Jan 30, 2020
- Sex
- Female
- 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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5302024818 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Woodward Detroit CVS, L.L.C. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302024818 | MI | Yes |
Addresses
Primary practice location
4514 Gratiot Rd
Kimball, MI 48074-4508
Mailing address
4514 Gratiot Rd
Kimball, MI 48074-4508
Phone (810) 364-6980
Other providers in Kimball, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 30, 2020. 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.