Provider Demographics
NPI:1528340205
Name:EHLERT, TODD MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:MICHAEL
Last Name:EHLERT
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 1:800 CAPITAL AVE NE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-5604
Mailing Address - Country:US
Mailing Address - Phone:269-965-3313
Mailing Address - Fax:269-965-8254
Practice Address - Street 1:800 CAPITAL AVE NE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-5604
Practice Address - Country:US
Practice Address - Phone:269-965-3313
Practice Address - Fax:269-965-8254
Is Sole Proprietor?:No
Enumeration Date:2011-09-19
Last Update Date:2011-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302037054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist