Provider Demographics
NPI:1740558535
Name:MACRAE, PATRICIA ERIN (PHARMD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ERIN
Last Name:MACRAE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:MI
Mailing Address - Zip Code:49635-9142
Mailing Address - Country:US
Mailing Address - Phone:231-352-8151
Mailing Address - Fax:
Practice Address - Street 1:401 MAIN ST
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:MI
Practice Address - Zip Code:49635-9142
Practice Address - Country:US
Practice Address - Phone:231-352-8151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-07
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302033717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist