Provider Demographics
NPI:1811589310
Name:TAYLOR, MICHAEL MORGAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:MORGAN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COUDERSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16915-1621
Mailing Address - Country:US
Mailing Address - Phone:814-274-8660
Mailing Address - Fax:814-274-8984
Practice Address - Street 1:101 N MAIN ST
Practice Address - Street 2:
Practice Address - City:COUDERSPORT
Practice Address - State:PA
Practice Address - Zip Code:16915-1621
Practice Address - Country:US
Practice Address - Phone:814-274-8660
Practice Address - Fax:814-274-8984
Is Sole Proprietor?:No
Enumeration Date:2021-02-05
Last Update Date:2021-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP437690183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist