Provider Demographics
NPI:1184826166
Name:COLEMAN, RITA O (RPH)
Entity type:Individual
Prefix:MRS
First Name:RITA
Middle Name:O
Last Name:COLEMAN
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1584 STIRLING LAKES DR
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48340-1373
Mailing Address - Country:US
Mailing Address - Phone:313-587-2398
Mailing Address - Fax:248-475-0971
Practice Address - Street 1:1900 E 8 MILE RD
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-1008
Practice Address - Country:US
Practice Address - Phone:313-892-4600
Practice Address - Fax:313-892-3753
Is Sole Proprietor?:No
Enumeration Date:2007-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302031675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist