Provider Demographics
NPI:1245834464
Name:CEFOLE, MICHAEL VINCENT (PHARMD, RPH, BC-ADM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:VINCENT
Last Name:CEFOLE
Suffix:
Gender:M
Credentials:PHARMD, RPH, BC-ADM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:89 LEWIS BAY RD STE 4
Mailing Address - Street 2:
Mailing Address - City:HYANNIS
Mailing Address - State:MA
Mailing Address - Zip Code:02601-5245
Mailing Address - Country:US
Mailing Address - Phone:508-418-6600
Mailing Address - Fax:508-796-2177
Practice Address - Street 1:89 LEWIS BAY RD STE 4
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-5245
Practice Address - Country:US
Practice Address - Phone:508-418-6600
Practice Address - Fax:508-796-2177
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-29
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPH237550183500000X
MACDTM100001411835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist