Provider Demographics
NPI:1801170097
Name:MORRIS, PATRICK (PHARM D)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
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 1:812 E SAGINAW HWY
Mailing Address - Street 2:
Mailing Address - City:GRAND LEDGE
Mailing Address - State:MI
Mailing Address - Zip Code:48837-8410
Mailing Address - Country:US
Mailing Address - Phone:517-627-1240
Mailing Address - Fax:517-627-1574
Practice Address - Street 1:812 E SAGINAW HWY
Practice Address - Street 2:
Practice Address - City:GRAND LEDGE
Practice Address - State:MI
Practice Address - Zip Code:48837-8410
Practice Address - Country:US
Practice Address - Phone:517-627-1240
Practice Address - Fax:517-627-1574
Is Sole Proprietor?:No
Enumeration Date:2011-10-05
Last Update Date:2011-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302038707183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist