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NPI Code Detail

MEDICARE: MONICA MARY FULLENKAMP PHARMD

MEDICARE: MONICA MARY FULLENKAMP PHARMD
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
1183500000XPharmacist03440913OH

General Provider Information

NPI Number : 1831838523
Entity Type Code : Individual
Provider Name (Legal Business Name) : MONICA MARY FULLENKAMP PHARMD
Provider Business Mailing Address
First Line : 2082 SAINT PETER RD
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-9705
Country : US
Telephone Number : 419-763-9591
Fax Number :
Provider Business Practice Location Address
First Line : 102 N WAYNE ST
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-8059
Country : US
Telephone Number : 419-375-2323
Fax Number : 419-375-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2022
Last Update Date : 06/01/2022

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Directions to “ MONICA MARY FULLENKAMP PHARMD” Practice Location

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