Provider Demographics
NPI:1275900045
Name:KEMPISTY, IAN (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:IAN
Middle Name:
Last Name:KEMPISTY
Suffix:
Gender:M
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35433 EDMUNDS GRV
Mailing Address - Street 2:
Mailing Address - City:NEW BALTIMORE
Mailing Address - State:MI
Mailing Address - Zip Code:48047-1198
Mailing Address - Country:US
Mailing Address - Phone:586-764-0891
Mailing Address - Fax:
Practice Address - Street 1:205 S RANGE RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:MI
Practice Address - Zip Code:48040-2605
Practice Address - Country:US
Practice Address - Phone:810-388-9610
Practice Address - Fax:810-388-9665
Is Sole Proprietor?:No
Enumeration Date:2015-08-27
Last Update Date:2015-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302040765183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist