Stacey Ann Bennett, R.PH.
Individual provider Active NPI Pharmacist · Lawton, MI
NPI 1851317820 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1851317820
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302029868 (MI)
- Practice address
- 350 N Main St
Lawton, MI 49065-9249 - Phone
- (269) 624-2231
- Fax
- (269) 624-5704
- NPI assigned
- Jul 14, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|
| 5302029868 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hometown Pharmacy Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302029868 | MI | Yes |
Addresses
Primary practice location
350 N Main St
Lawton, MI 49065-9249
Mailing address
4449 S 1St St
Kalamazoo, MI 49009
Phone (269) 806-0421
Other names
- Ms. Stacy Ann Robinson
Other providers in Lawton, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.