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NPI Code Detail

MEDICARE: KENDRA M PETERS RPH

MEDICARE:   KENDRA M PETERS  RPH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03-3-18716OH

General Provider Information

NPI Number : 1013037290
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDRA M PETERS RPH
Provider Business Mailing Address
First Line : 3417 BRADDOCK ST
Second Line :
City : KETTERING
State : OH
Zip : 45420-1266
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 18 CHILDRENS PLZ
Second Line :
City : DAYTON
State : OH
Zip : 45404-1816
Country : US
Telephone Number : 937-641-5428
Fax Number : 937-641-5474
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/30/2007
Last Update Date : 07/08/2007

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Directions to “ KENDRA M PETERS RPH” Practice Location

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