Healthcare Provider Details

I. General information

NPI: 1639158884
Provider Name (Legal Business Name): PATRICK ALAN KOVACS RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2006
Last Update Date: 03/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

148 EAST MAIN ST
BARNESVILLE OH
43713
US

IV. Provider business mailing address

148 EAST MAIN ST
BARNESVILLE OH
43713
US

V. Phone/Fax

Practice location:
  • Phone: 740-425-1582
  • Fax:
Mailing address:
  • Phone: 740-425-1582
  • Fax: 740-425-1795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-20573
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: