Healthcare Provider Details

I. General information

NPI: 1518561695
Provider Name (Legal Business Name): KIMBERLY SEFCIK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2020
Last Update Date: 11/30/2020
Certification Date: 11/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 LOCKBOURNE RD
COLUMBUS OH
43206-3736
US

IV. Provider business mailing address

1500 LOCKBOURNE RD
COLUMBUS OH
43206-3736
US

V. Phone/Fax

Practice location:
  • Phone: 614-449-9771
  • Fax:
Mailing address:
  • Phone: 614-449-9771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03236767
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: