Provider Demographics
NPI:1710095831
Name:KELBEL PHARMACY INC.
Entity Type:Organization
Organization Name:KELBEL PHARMACY INC.
Other - Org Name:KELBEL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LEANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:KELBEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:231-526-5971
Mailing Address - Street 1:205 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HARBOR SPRINGS
Mailing Address - State:MI
Mailing Address - Zip Code:49740-1511
Mailing Address - Country:US
Mailing Address - Phone:231-526-5971
Mailing Address - Fax:231-526-0376
Practice Address - Street 1:205 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HARBOR SPRINGS
Practice Address - State:MI
Practice Address - Zip Code:49740-1511
Practice Address - Country:US
Practice Address - Phone:231-526-5971
Practice Address - Fax:231-526-0376
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2016-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6380333600000X
MI53010063803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy