Healthcare Provider Details

I. General information

NPI: 1215462445
Provider Name (Legal Business Name): ROBERT KERNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2017
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W COSHOCTON ST
JOHNSTOWN OH
43031-8904
US

IV. Provider business mailing address

4970 SMOKETALK LN
WESTERVILLE OH
43081-4433
US

V. Phone/Fax

Practice location:
  • Phone: 740-966-8310
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03335124
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: