Provider Demographics
NPI:1699185918
Name:BOLDEN-HOWARD, CYNTHIA (RPH)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:
Last Name:BOLDEN-HOWARD
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 1:2900 N. SAGINAW ST
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48505
Mailing Address - Country:US
Mailing Address - Phone:810-787-5092
Mailing Address - Fax:810-237-6005
Practice Address - Street 1:2900 N. SAGINAW ST
Practice Address - Street 2:
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48505
Practice Address - Country:US
Practice Address - Phone:810-787-5092
Practice Address - Fax:810-237-6005
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-08
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302025344183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist