Healthcare Provider Details

I. General information

NPI: 1497832612
Provider Name (Legal Business Name): DONALD GERARD GROFF RPH, CGP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8264 W STATE ROUTE 41
COVINGTON OH
45318-1248
US

IV. Provider business mailing address

217 HADLEY AVE
DAYTON OH
45419-2609
US

V. Phone/Fax

Practice location:
  • Phone: 800-232-4239
  • Fax:
Mailing address:
  • Phone: 937-294-8780
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number03-2-19515
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number5302033589
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number26020244A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: