Provider Demographics
NPI:1629489984
Name:KASPO, MONA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MONA
Middle Name:
Last Name:KASPO
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3175 S ROCHESTER RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5042
Mailing Address - Country:US
Mailing Address - Phone:248-844-5033
Mailing Address - Fax:248-844-5065
Practice Address - Street 1:3175 S ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-5042
Practice Address - Country:US
Practice Address - Phone:248-844-5033
Practice Address - Fax:248-844-5065
Is Sole Proprietor?:No
Enumeration Date:2014-05-08
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI53020317071835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy