Provider Demographics
NPI:1093954281
Name:PERSONALIZED PHARMACIST SERVICES PLLC
Entity Type:Organization
Organization Name:PERSONALIZED PHARMACIST SERVICES PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEIBERT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:269-569-4662
Mailing Address - Street 1:2587 HUNTERS PT
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-6115
Mailing Address - Country:US
Mailing Address - Phone:269-569-4662
Mailing Address - Fax:
Practice Address - Street 1:2587 HUNTERS PT
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-6115
Practice Address - Country:US
Practice Address - Phone:269-569-4662
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-11
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024356183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty