Provider Demographics
NPI:1467887802
Name:BIENIEK, KALA (PHARM D)
Entity Type:Individual
Prefix:DR
First Name:KALA
Middle Name:
Last Name:BIENIEK
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:HART
Mailing Address - State:MI
Mailing Address - Zip Code:49420-1236
Mailing Address - Country:US
Mailing Address - Phone:231-873-2540
Mailing Address - Fax:
Practice Address - Street 1:819 S STATE ST
Practice Address - Street 2:
Practice Address - City:HART
Practice Address - State:MI
Practice Address - Zip Code:49420-1236
Practice Address - Country:US
Practice Address - Phone:231-873-2540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist