Duane Allen, R.PH.
Individual provider Active NPI Pharmacist · Kalkaska, MI
NPI 1770030488 · NPPES record last updated Jul 18, 2018
Key facts
- NPI
- 1770030488
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 3817 (WY)
- Practice address
- 784 South Cedar St Ste E
Kalkaska, MI 49646 - Phone
- (307) 324-5276
- Fax
- (307) 324-5277
- NPI assigned
- Sep 10, 2016
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 3817 | WY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shopko Stores Operating Co LLC | Past | Accepting new patients | |
| Shopko Stores Operating Co. LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 3817 | WY | Yes |
Addresses
Primary practice location
784 South Cedar St Ste E
Kalkaska, MI 49646
Mailing address
429 Munson PL Apt 8
Traverse City, MI 49686-3065
Phone (307) 321-9009
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770030488 | Other | WY | 1770030488 |
| 1770030488 | Medicaid | WY |
Other providers in Kalkaska, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 18, 2018. 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.