Provider Demographics
NPI:1134347784
Name:COLE, PATRICIA ALICE (PHARM D)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ALICE
Last Name:COLE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14388 NORTH LAKE RD
Mailing Address - Street 2:
Mailing Address - City:GREGORY
Mailing Address - State:MI
Mailing Address - Zip Code:48137
Mailing Address - Country:US
Mailing Address - Phone:734-475-7951
Mailing Address - Fax:
Practice Address - Street 1:221 DINO DRIVE
Practice Address - Street 2:SUITE B
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103
Practice Address - Country:US
Practice Address - Phone:734-792-9001
Practice Address - Fax:734-792-9052
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302410982183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist