Provider Demographics
NPI:1720691983
Name:AMLOTT, HAILEY (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:HAILEY
Middle Name:
Last Name:AMLOTT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 LORI ANN DR
Mailing Address - Street 2:
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2544
Mailing Address - Country:US
Mailing Address - Phone:231-942-1615
Mailing Address - Fax:
Practice Address - Street 1:WALGREENS 07660
Practice Address - Street 2:1220 N. MITCHELL STREET
Practice Address - City:CADILLAC
Practice Address - State:MI
Practice Address - Zip Code:49601
Practice Address - Country:US
Practice Address - Phone:231-775-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-27
Last Update Date:2020-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302412839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist