Provider Demographics
NPI:1821533142
Name:MARTIN, RACHELLE TRONO (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:RACHELLE
Middle Name:TRONO
Last Name:MARTIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:RACHELLE
Other - Middle Name:REYES
Other - Last Name:TRONO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:11350 J DR S
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49029-9756
Mailing Address - Country:US
Mailing Address - Phone:269-339-5883
Mailing Address - Fax:
Practice Address - Street 1:13201 STEPHENS RD
Practice Address - Street 2:SUITE B
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48089-4340
Practice Address - Country:US
Practice Address - Phone:877-899-6337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-21
Last Update Date:2016-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302043046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist