Provider Demographics
NPI:1285634410
Name:POIRIER, DAVID VINCENT II (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:VINCENT
Last Name:POIRIER
Suffix:II
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 1:1242 COOPER LAKE RD
Mailing Address - Street 2:
Mailing Address - City:ISHPEMING
Mailing Address - State:MI
Mailing Address - Zip Code:49849-3347
Mailing Address - Country:US
Mailing Address - Phone:906-486-8641
Mailing Address - Fax:
Practice Address - Street 1:1242 COOPER LAKE RD
Practice Address - Street 2:
Practice Address - City:ISHPEMING
Practice Address - State:MI
Practice Address - Zip Code:49849-3347
Practice Address - Country:US
Practice Address - Phone:906-486-8641
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI23184183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist