Healthcare Provider Details

I. General information

NPI: 1336205806
Provider Name (Legal Business Name): CURTIS C BONE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 S DIXON RD
KOKOMO IN
46902-6411
US

IV. Provider business mailing address

4144 LAKE WINDEMERE LN
KOKOMO IN
46902-9413
US

V. Phone/Fax

Practice location:
  • Phone: 765-455-5418
  • Fax: 765-455-5724
Mailing address:
  • Phone: 765-963-6520
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26013735A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: