Provider Demographics
NPI:1609351063
Name:FRANKLIN, CHONA TANTOCO (RPH)
Entity Type:Individual
Prefix:
First Name:CHONA
Middle Name:TANTOCO
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CHONA
Other - Middle Name:TANTOCO
Other - Last Name:BONDOC
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:24800 HOOVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48089-1965
Mailing Address - Country:US
Mailing Address - Phone:586-486-5008
Mailing Address - Fax:586-486-5744
Practice Address - Street 1:24800 HOOVER RD STE B
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-1965
Practice Address - Country:US
Practice Address - Phone:586-486-5008
Practice Address - Fax:586-486-5744
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302041139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist