Provider Demographics
NPI:1396810040
Name:GOLD, HAROLD (RPH)
Entity type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:
Last Name:GOLD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6580 RIDGEFIELD
Mailing Address - Street 2:202
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-3040
Mailing Address - Country:US
Mailing Address - Phone:248-788-2533
Mailing Address - Fax:
Practice Address - Street 1:7800 W OUTER DRIVE
Practice Address - Street 2:HENRY FORD NORTHWEST PHARMACY
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48235
Practice Address - Country:US
Practice Address - Phone:313-653-2039
Practice Address - Fax:313-255-2091
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI17957183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist