Provider Demographics
NPI:1073777397
Name:DRAKE, AARON MATTHEW (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MATTHEW
Last Name:DRAKE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 E COLUMBIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49014-5159
Mailing Address - Country:US
Mailing Address - Phone:269-964-9467
Mailing Address - Fax:
Practice Address - Street 1:1250 EAST COLUMBIA AVENUE
Practice Address - Street 2:SUITE B
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49014
Practice Address - Country:US
Practice Address - Phone:269-964-9467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2008-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist