Individual provider · Type 1 NPI

Dominique Marie Patthanachardenphon, PharmD

Pharmacist · Grand Rapids, MI

NPI number 1871618967 Active

Practice location

665 Seward Ave NW Ste 320
Grand Rapids, MI 49504-5190

Call (616) 267-7029 Map

Mailing address

665 Seward Ave NW # Suite 320
Grand Rapids, MI 49504-5190

Specialties and licenses

TaxonomyCodeLicense
Pharmacist Primary 183500000X051-289748 (IL)

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 1871618967

Dominique Marie Patthanachardenphon, PharmD's National Provider Identifier is 1871618967, issued on Mar 20, 2007. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Grand Rapids, MI. The record was last updated on Jun 14, 2017.