Provider Demographics
NPI:1518344720
Name:BORGESS MEDICAL CENTER (INPATIENT PHARMACY)
Entity Type:Organization
Organization Name:BORGESS MEDICAL CENTER (INPATIENT PHARMACY)
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:EARLY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:269-226-5685
Mailing Address - Street 1:1521 GULL RD
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49048-1640
Mailing Address - Country:US
Mailing Address - Phone:269-226-5922
Mailing Address - Fax:269-226-8173
Practice Address - Street 1:1521 GULL RD
Practice Address - Street 2:
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49048-1640
Practice Address - Country:US
Practice Address - Phone:269-226-5922
Practice Address - Fax:269-226-8173
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-27
Last Update Date:2015-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53010021983336I0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336I0012XSuppliersPharmacyInstitutional Pharmacy