Provider Demographics
NPI:1962185264
Name:PRITCHARD, SAMANTHA TAYLOR (PHARMD)
Entity type:Individual
Prefix:DR
First Name:SAMANTHA
Middle Name:TAYLOR
Last Name:PRITCHARD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:253 BENDON RD
Mailing Address - Street 2:
Mailing Address - City:INTERLOCHEN
Mailing Address - State:MI
Mailing Address - Zip Code:49643-9698
Mailing Address - Country:US
Mailing Address - Phone:989-274-9986
Mailing Address - Fax:
Practice Address - Street 1:1029 S M 37
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49685-8508
Practice Address - Country:US
Practice Address - Phone:231-943-3147
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302415411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist