Provider Demographics
NPI:1881940997
Name:HOWELL, MICAH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:MICAH
Middle Name:
Last Name:HOWELL
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1409 BELT LINE RD
Mailing Address - Street 2:
Mailing Address - City:COLLINSVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62234-4359
Mailing Address - Country:US
Mailing Address - Phone:618-779-6943
Mailing Address - Fax:
Practice Address - Street 1:6671 EDWARDSVILLE CROSSING DR
Practice Address - Street 2:
Practice Address - City:EDWARDSVILLE
Practice Address - State:IL
Practice Address - Zip Code:62025-2704
Practice Address - Country:US
Practice Address - Phone:618-307-3817
Practice Address - Fax:618-307-3819
Is Sole Proprietor?:No
Enumeration Date:2012-07-26
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051296055183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist