Healthcare Provider Details

I. General information

NPI: 1801311022
Provider Name (Legal Business Name): GREG VOLMER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2017
Last Update Date: 06/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3050 MACK RD STE 330
FAIRFIELD OH
45014-5381
US

IV. Provider business mailing address

11621 KETTERING DR
CINCINNATI OH
45251-4618
US

V. Phone/Fax

Practice location:
  • Phone: 513-557-7650
  • Fax:
Mailing address:
  • Phone: 513-235-3168
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number100105360887409
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: