Fantich, Kevin

Fantich, Kevin is an individual health care provider with primary practice located at 26711 Northwestern Highway Suite 400, Southfield MI 48033-2154. He recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist, Pharmacy Service Providers / Pharmacist. Pharmacy Service Providers / Pharmacist is his primary health care specialty. Fantich, Kevin can be contacted via phone (248) 948-9900.

Contact Information

Primary practice address
26711 Northwestern Highway Suite 400 Southfield MI 48033-2154
Phone: (248) 948-9900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PS48603 Florida
Pharmacy Service Providers / Pharmacist 183500000X 5302035536 Michigan

Profile Details

NPI number 1316113921
LBN Legal business name Fantich, Kevin
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2008
Last updated Aug 27th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316113921 NPPES
Michigan Other 5302035536 MI CONTROLLED SUBSTANCE LICENSE
Michigan Other PS48603 MI CONTROLLED SUBSTANCE LICENSE

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