NPI 1104544071

Derrick Bacon, PHARMACYTECH

Practitioner Pharmacy Technician Pontiac, MI

Practice location

Address: 360 Martin Luther King Jr Blvd N, Pontiac, MI 48342-1712
Phone: (248) 332-0602

Registered specialties

Pharmacy Technician Primary

Pharmacy Service Providers Taxonomy 183700000X Licence 5303041916 (MI)

Other Pharmacy Technician providers in Michigan →

Registry record

NPI: 1104544071
Entity type: Individual
Sex (as registered): Male
NPI issued: 17 Aug 2022
Record last updated: 17 Aug 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.