Cavanaugh, Mitchell
Cavanaugh, Mitchell is an individual health care provider with primary practice located at 1175 Wilson Ave Nw , Walker MI 49534-6407. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Pharmacy Service Providers / Ambulatory Care. Pharmacy Service Providers / Ambulatory Care is his primary health care specialty. Cavanaugh, Mitchell can be contacted via phone (616) 685-8650.Contact Information
Primary practice address
1175 Wilson Ave Nw
Walker MI 49534-6407
Phone: (616) 685-8650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | 5351013221 | Michigan |
| Pharmacy Service Providers / Ambulatory Care | 1835P2201X | 5302412556 | Michigan |
Profile Details
| NPI number | 1932667144 |
|---|---|
| LBN Legal business name | Cavanaugh, Mitchell |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 6th, 2019 |
| Last updated | Dec 16th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932667144 | NPPES |
| Michigan | Other | 5302412556 | PHARMACIST LICENSE |
| Michigan | Other | 5315219725 | PHARMACIST LICENSE |
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