OPAL M BACON (NPI# 1285177493) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285177493 |
| Entity Type | Individual |
| Full Name | OPAL M BACON |
| Credential | PHARMD |
| Practice Address |
1 Ford Place, 1c Outpatient Psychiatry Detroit MI 48202 |
| Mailing Address |
2065 Anita Ave Grosse Pointe Woods MI 48236-1427 |
| Practice Telephone | 3135567882 |
| Practice Fax Number | 3138746650 |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2016-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P1300X |
Pharmacist Specialization: Psychiatric |
5302044753 | MI | Pharmacy Service Providers |
| Street Address |
1 FORD PLACE, 1C OUTPATIENT PSYCHIATRY |
| City | DETROIT |
| State | MI |
| Zip Code | 48202 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710584602 | Andrea Irene Martin | Audiologist | 2799 E Grand Blvd, Detroit, MI 48202 | 2020-10-05 |
| 1174132583 | Odei Alayyas | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Boulevard Henry Ford Hospital, Medical Ed, Detroit, MI 48202 | 2020-07-31 |
| 1912529801 | Aroob Nabil Nimer Sweidan | Student in an Organized Health Care Education/Training Program | 2799 West Grand Boulvard, Department of Internal Meidicine, Cfp 1, Detroit, MI 48202 | 2020-05-13 |
| 1306485636 | Katie Burlen-davis | Registered Nurse | 9045 Woodward Ave, Detroit, MI 48202 | 2020-01-03 |
| 1407401250 | Santhalakshmi Angappan | Student in an Organized Health Care Education/Training Program | Henry Ford Hospital Medical Education Department, 2799 W. Grand Boulevard, Detroit, MI 48202 | 2019-08-08 |
| 1851945687 | Walter Mitini Etoh | Nurse Practitioner | Henry Ford Hospital I1 Observation, 2799 W. Grand Blvd, Detroit, MI 48202 | 2019-07-30 |
| 1467913756 | Andrew Michael Schock | Emergency Medicine | Ceci Murrell-harvey, Henry Ford Hospital, 2799 W. Grand. Blvd, Cfp 046, Detroit, MI 48202 | 2019-03-28 |
| 1700363892 | Zaid Al-saheli | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvdl, Cfp 046, Hope Peck, Detroit, MI 48202 | 2018-07-23 |
| 1932690096 | Yusuf Naser Alalwan | Student in an Organized Health Care Education/Training Program | 2799 W. Grand Blvd. Henry Ford Hospital - Gme Office, Detroit, MI 48202 | 2018-05-24 |
| 1568952729 | Kelvin Sellers | Massage Therapist | 832 Seward, Detriot, MI 48202 | 2018-05-14 |
| Find all providers in zip 48202 | ||||
| Taxonomy Code | 1835P1300X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Psychiatric |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in optimizing care of patients with psychiatric illness by assessing and monitoring patients, recognizing drug-induced problems, and recommending appropriate treatment plans. |
| Notes: Source: Specialty certification and recertification program administered by Board of Pharmaceutical Specialties, www.bpsweb.org [7/1/2006: modified title, added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003927658 | Peter Anthony Reilly | Pharmacist | 4646 John R St, Pharmacy Section, Detroit, MI 48201-1916 | 2006-08-31 |
| 1619080348 | Josephene N Lee | Pharmacist | 4646 John R St, Detroit, MI 48201-1916 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801323316 | Anthony Larouche | Pharmacist | 500 Hancock St Ste 100, Saginaw, MI 48602-4224 | 2017-05-15 |
| 1457437873 | Patricia Jane Jones | Pharmacist | 2676 Dorchester Rd, Birmingham, MI 48009-5989 | 2006-10-27 |
| 1053313973 | Richard Charles Bercou | Pharmacist | 23025 Old Orchard Trl, Bingham Farms, MI 48025-3432 | 2005-08-11 |
| 1871101394 | Cherisse Norberte | Pharmacist | 325 E H St, Iron Mountain, MI 49801-4760 | 2020-07-21 |
| 1255984233 | Andrew Saul | Pharmacist | 1500 Weiss St, Saginaw, MI 48602-5251 | 2019-07-19 |
| 1336551738 | Ferdnand Chisom Osuagwu | Pharmacist | 1000 Houghton Ave, Saginaw, MI 48602-5303 | 2014-05-20 |
| 1952734923 | Chelsea N Clark | Pharmacist | 5500 Armstrong Rd, 119a, Battle Creek, MI 49037-7314 | 2013-08-14 |
| 1609130640 | Shruti Chopra | Pharmacist | 5500 Armstrong Rd, Vamc Pharmacy -119a, Battle Creek, MI 49037-7314 | 2012-06-25 |
| 1669695987 | Kimberly Ann Hedrich | Pharmacist | 1200 N West Ave, Suite 500, Jackson, MI 49202-2179 | 2007-04-11 |
| 1508976861 | Rebecca Lee Jones | Pharmacist | 5500 Armstrong Rd, Battle Creek, MI 49037-7314 | 2006-08-30 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.