Provider Demographics
NPI:1831411644
Name:KUZMITS, H MICHELLE (RPH)
Entity type:Individual
Prefix:MRS
First Name:H
Middle Name:MICHELLE
Last Name:KUZMITS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9982 S SAINT ANDREWS LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-8146
Mailing Address - Country:US
Mailing Address - Phone:812-824-3982
Mailing Address - Fax:
Practice Address - Street 1:3216 E 3RD ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-5427
Practice Address - Country:US
Practice Address - Phone:812-336-8426
Practice Address - Fax:812-336-4381
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-20
Last Update Date:2010-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26018239A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist