Manuel, Gervasis

Manuel, Gervasis is an individual health care provider with primary practice located at 2845 W Cleveland Rd , South Bend IN 46628-6188. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Manuel, Gervasis can be contacted via phone (574) 277-1538.

Contact Information

Primary practice address
2845 W Cleveland Rd South Bend IN 46628-6188
Phone: (574) 277-1538
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 5302035864 Michigan

Profile Details

NPI number 1235262395
LBN Legal business name Manuel, Gervasis
Credentials PHARM.D
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 14th, 2007
Last updated Jan 26th, 2011 - about 13 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 1235262395 NPPES
Michigan Other 5302035864 LICENSE
Michigan Other 26022347A LICENSE
Michigan Other 051291744 LICENSE

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