Derrick Bacon, PHARMACY TECH

NPI #1104544071 in Pontiac, Michigan

Provider Information

NPI Number: 1104544071
Entity Type: Individual
Name: Derrick Bacon, PHARMACY TECH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacy Technician
Credential: PHARMACY TECH
Enumeration Date: Aug 17, 2022
Last Updated: Aug 17, 2022

Practice Location

Address: 360 MARTIN LUTHER KING JR BLVD N
City: Pontiac
State: Michigan
ZIP Code: 48342-1712
Phone: (248) 332-0602

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy Technician	183700000X	Primary

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