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NPI Code Detail

MEDICARE: OHIO UNIVERSITY STUDENT HEALTH SERVICE PHARMACY

MEDICARE: OHIO UNIVERSITY STUDENT HEALTH SERVICE PHARMACY
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
13336C0002XClinic Pharmacy020255150OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13676814OTHEROTHER ID NUMBER

General Provider Information

NPI Number : 1578576625
Entity Type Code : Organization
Provider Name (Legal Business Name) : OHIO UNIVERSITY STUDENT HEALTH SERVICE PHARMACY
Provider Business Mailing Address
First Line : 2 HEALTH CENTER DR
Second Line :
City : ATHENS
State : OH
Zip : 45701-2907
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2 HEALTH CENTER DR
Second Line :
City : ATHENS
State : OH
Zip : 45701-2907
Country : US
Telephone Number : 740-593-4738
Fax Number : 740-597-1834
Authorized Official
Title or Position : PHARMACIST SUPERVISOR
Name : DANIEL HUDSON
Credential :
Telephone Number : 740-593-4738
Provider Enumeration Date : 08/13/2006
Last Update Date : 04/25/2008

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Directions to “OHIO UNIVERSITY STUDENT HEALTH SERVICE PHARMACY ” Practice Location

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