Healthcare Provider Details

I. General information

NPI: 1316045446
Provider Name (Legal Business Name): RICHARD POWELL KUGELE RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3200 VINE ST
CINCINNATI OH
45220-2213
US

IV. Provider business mailing address

4052 JOHNSON FORK RD
WEST HARRISON IN
47060-9631
US

V. Phone/Fax

Practice location:
  • Phone: 513-861-3100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-3-11681
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: