Provider Demographics
NPI:1194474890
Name:KOKA, ARJOL (PHARMD)
Entity type:Individual
Prefix:
First Name:ARJOL
Middle Name:
Last Name:KOKA
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 1:907 MINNESOTA DR APT 1
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4439
Mailing Address - Country:US
Mailing Address - Phone:248-808-7764
Mailing Address - Fax:
Practice Address - Street 1:3681 SHAWNEE RD
Practice Address - Street 2:
Practice Address - City:BRIDGMAN
Practice Address - State:MI
Practice Address - Zip Code:49106-9713
Practice Address - Country:US
Practice Address - Phone:269-465-6777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302413137183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist