Edward Isaac Betel, RPH
Individual provider Active NPI Pharmacist · Milford, MI
NPI 1962637017 · NPPES record last updated May 19, 2009
Key facts
- NPI
- 1962637017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 5302021524 (MI)
- Practice address
- 640 N Milford Rd
Milford, MI 48381-1534 - Phone
- (248) 676-2916
- NPI assigned
- May 19, 2009
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| 5302021524 | MI | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perry Drug Stores Inc and Subsidiaries | Past | Accepting new patients | |
| Perry Drug Stores Inc and Subsidiaries | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 5302021524 | MI | Yes |
Addresses
Primary practice location
640 N Milford Rd
Milford, MI 48381-1534
Mailing address
640 N Milford Rd
Milford, MI 48381-1534
Phone (248) 676-2916
Other providers in Milford, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 19, 2009. 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.