DERRICK BACON PHARMACY TECH NPI 1104544071

NPI Information

  • NPI: 1104544071
  • Provider Name: DERRICK BACON, PHARMACY TECH
  • Classification: Pharmacy Technician - 183700000X
  • Entity Type: Individual
  • Address: 360 MARTIN LUTHER KING JR BLVD N
    PONTIAC, MI
    ZIP 48342
  • Phone: (248) 332-0602

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NPI Details

Derrick Bacon, PHARMACY TECH is a pharmacy technician in Pontiac, MI. The provider is a person who works under the direct supervision of a licensed pharmacist and performs many pharmacy-related functions that do not require the professional judgment of a pharmacist. Derrick Bacon, PHARMACY TECH NPI is 1104544071. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

360 MARTIN LUTHER KING JR BLVD N
PONTIAC, MI
ZIP 48342-712
Phone: (248) 332-0602

The enumeration date for this NPI number is 8/17/2022 and was last updated on 8/17/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1183700000XPharmacy Technician5303041916MICHIGANYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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