MR. RUDOLPH L BOLF (NPI# 1659578003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659578003 |
| Entity Type | Individual |
| Full Name | MR. RUDOLPH L BOLF |
| Credential | RPH, MSA |
| Practice Address |
10442 Dogwood Ln Otisville MI 48463-9798 |
| Practice Telephone | 8107935168 |
| Practice Fax Number | 9896357171 |
| Mailing Telephone | 8107935168 |
| Mailing Fax Number | 9896357171 |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 5302021911 | MI | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | REGISTERED PHARMACIST LIC | 5302021911 | 01 |
| Street Address |
10442 DOGWOOD LN |
| City | OTISVILLE |
| State | MI |
| Zip Code | 48463-9798 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568554681 | Great Lakes Family Dental Group - Otisville, P.C. | Dentist | 380 N State, Otisville, MI 48463 | 2006-09-28 |
| 1285696682 | George Mohamedally Do PC | Family Medicine | 387 North State, Otisville, MI 48463 | 2006-04-03 |
| 1407376536 | Kelsey Jo Penix | Counselor | 9445 Patricia Dr, Otisville, MI 48463-9406 | 2017-06-20 |
| 1760972806 | Jimmy Dale Colley Jr. | Occupational Therapist | 9179 Frances Rd, Otisville, MI 48463-9411 | 2018-05-15 |
| 1285124537 | Dennys Pharmacy LLC | Pharmacy | 410 N State Rd, Otisville, MI 48463-9443 | 2018-05-12 |
| 1114313459 | Shelly Denise Hatchew | Physical Therapy Assistant | 9099 Dodge Rd, Otisville, MI 48463-9449 | 2015-04-14 |
| 1780859363 | Thomas W Wood | Pharmacist | 337 N State Rd, Otisville, MI 48463-9486 | 2008-04-24 |
| 1669503991 | Mary Joy Dela Rosa | Physical Therapist | 391 N State Rd, Suite A, Otisville, MI 48463-9486 | 2007-03-08 |
| 1760574974 | William E Norton II | Dentist | 380 N State Rd, Otisville, MI 48463-9486 | 2006-09-28 |
| 1932218492 | Rite Aid of Michigan Inc | Durable Medical Equipment & Medical Supplies | 337 North State Road, Otisville, MI 48463-9486 | 2006-08-29 |
| Find all providers in zip 48463 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780859363 | Thomas W Wood | Pharmacist | 337 N State Rd, Otisville, MI 48463-9486 | 2008-04-24 |
| 1578681383 | John William Claar | Pharmacist | 2 Mile Dr, Fci Otisville Pharmacy, Otisville, NY 10963 | 2007-03-27 |
| 1518579853 | Tijo Thomas Manthuruthil | Pharmacist | 337 N State Rd, Otisville, MI 48463-9486 | 2020-08-18 |
| 1538459573 | William Dennis Berry | Pharmacist | 337 N State Rd, Otisville, MI 48463-9486 | 2011-04-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477710 | Alix Sabbagh | Pharmacist | 154 River Ln, Dearborn, MI 48124-1047 | 2020-11-04 |
| 1659972867 | Bruce Alan Gilmore | Pharmacist | 5940 Augusta Ln, Grand Blanc, MI 48439-9473 | 2020-11-04 |
| 1437750551 | Anamiben R Patel | Pharmacist | 45555 Michigan Ave, Canton, MI 48188-2388 | 2020-11-04 |
| 1871194217 | Rajesh Koduru | Pharmacist | 27496 Pamplona Ln, Novi, MI 48374-4208 | 2020-11-03 |
| 1346841962 | Joy Emery | Pharmacist | 1770 N Alger Road, Alma, MI 48001 | 2020-11-02 |
| 1659972107 | Jane Gruenke | Pharmacist | N10305 Country Club Rd, Ironwood, MI 49938-9627 | 2020-11-02 |
| 1407456254 | Bradley Dwane Murphy | Pharmacist | 6170 S Saginaw, Grand Blanc, MI 48439 | 2020-10-30 |
| 1811597602 | Rachel L Martin | Pharmacist | 600 N Center Ave, Gaylord, MI 49735-1506 | 2020-10-29 |
| 1760081467 | Sam Nasser | Pharmacist | 6610 Reuter St, Dearborn, MI 48126-1898 | 2020-10-22 |
| 1427656990 | Tejal Shah | Pharmacist | 1153 Pembroke Dr, Rochester Hills, MI 48307-5756 | 2020-10-15 |
| 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.