Michael Allen Eddy, PHARMD
Individual provider Active NPI Pharmacist · Saint Marys, KS
NPI 1598065112 · NPPES record last updated Apr 15, 2014
Key facts
- NPI
- 1598065112
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 1-13105 (KS)
- Practice address
- 520 W Bertrand Ave
Saint Marys, KS 66536-1695 - Phone
- (785) 437-2967
- NPI assigned
- Oct 29, 2010
- Sex
- Male
- 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 |
|---|---|---|---|
| 1-13105 | KS | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 1-13105 | KS | Yes |
Addresses
Primary practice location
520 W Bertrand Ave
Saint Marys, KS 66536-1695
Mailing address
520 W Bertrand Ave
Saint Marys, KS 66536-1695
Phone (785) 437-2967
Other providers in Saint Marys, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 15, 2014. 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.