Provider Demographics
NPI:1093041345
Name:OAKLAWN HOSPITAL
Entity Type:Organization
Organization Name:OAKLAWN HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH MHA
Authorized Official - Phone:269-789-3905
Mailing Address - Street 1:200 NORTH MADISON ST.
Mailing Address - Street 2:ATTN: PHARMACY
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1143
Mailing Address - Country:US
Mailing Address - Phone:269-789-3905
Mailing Address - Fax:269-789-3975
Practice Address - Street 1:200 N MADISON ST
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1143
Practice Address - Country:US
Practice Address - Phone:269-789-3905
Practice Address - Fax:269-789-3975
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010011253336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2373304OtherNCPDP PROVIDER IDENTIFICATION NUMBER