Individual provider · Type 1 NPI
Kelly Jo Thiede, RPH
Pharmacist · Portage, MI
Practice location
6330 S Westnedge Ave
Portage, MI 49002-3572
Fax (269) 327-6740
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist Primary | 183500000X | 5302411010 (MI) |
Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…
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About NPI 1255682746
Kelly Jo Thiede, RPH's National Provider Identifier is 1255682746, issued on Sep 25, 2012. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Portage, MI. The record was last updated on Sep 25, 2012.