Provider Demographics
NPI:1164604617
Name:FILA, RICHARD LEE (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LEE
Last Name:FILA
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:514 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NORWAY
Mailing Address - State:MI
Mailing Address - Zip Code:49870-1238
Mailing Address - Country:US
Mailing Address - Phone:906-563-5151
Mailing Address - Fax:906-563-5978
Practice Address - Street 1:514 MAIN ST
Practice Address - Street 2:
Practice Address - City:NORWAY
Practice Address - State:MI
Practice Address - Zip Code:49870-1238
Practice Address - Country:US
Practice Address - Phone:906-563-5151
Practice Address - Fax:906-563-5978
Is Sole Proprietor?:No
Enumeration Date:2007-11-27
Last Update Date:2007-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302024687183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
2347107OtherCCRX MEDICARE PT D
2347107OtherADVANTRA MED PT D
MI2347107Medicaid
2347107OtherPHAMACARE MEDICARE PT D
2347107OtherWELL CARE MEDICARE PT D
2347107OtherRX SOLN MEDICARE PT D
WI33169900OtherWISCONSIN MEDICAID
MI2347107OtherMI BC MEDICARE PT D
2347107OtherAETNA MECIARE PT D
2347107OtherUNICARE MEDICARE PT D
2347107OtherHUMANA MEDICARE PT D
2347107Other4D MEDICARE PT D
2347107OtherUARXPDP MED PT D
2347107OtherCIGNATURE MED PT D
2347107OtherPAID MEDICARE PT D
2347107OtherRX AMERICA MED PT D
2347107OtherRX SOLUTION
2347107OtherRX AMERICA MED PT D