Provider Demographics
NPI:1356013676
Name:COLE, MORGAN R (PHARMD)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:R
Last Name:COLE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 MICHIGAN ST. NE
Mailing Address - Street 2:MAIL CODE 9001
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49503
Mailing Address - Country:US
Mailing Address - Phone:616-486-0646
Mailing Address - Fax:616-459-1909
Practice Address - Street 1:426 MICHIGAN ST. NE
Practice Address - Street 2:MAIL CODE 9001
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503
Practice Address - Country:US
Practice Address - Phone:616-267-8338
Practice Address - Fax:616-459-1909
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020363321835P2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P2201XPharmacy Service ProvidersPharmacistAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5302036332OtherSTATE OF MICHIGAN PHARMACIST