Provider Demographics
NPI:1164747846
Name:CAIN, MICHAEL HOWARD (RPH)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:HOWARD
Last Name:CAIN
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 1:17558 142ND AVE
Mailing Address - Street 2:
Mailing Address - City:JIM FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54748-2355
Mailing Address - Country:US
Mailing Address - Phone:715-271-3556
Mailing Address - Fax:
Practice Address - Street 1:2677 S PRAIRIE VIEW RD
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-7506
Practice Address - Country:US
Practice Address - Phone:715-726-6125
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2015-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI9195-40183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist