Healthcare Provider Details

I. General information

NPI: 1932215183
Provider Name (Legal Business Name): HEIDI DENISE KAUSER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N WILLIAMS ST
PAULDING OH
45879-1281
US

IV. Provider business mailing address

10146 STATE ROUTE 500
PAULDING OH
45879-9174
US

V. Phone/Fax

Practice location:
  • Phone: 419-399-2023
  • Fax: 419-399-9004
Mailing address:
  • Phone: 419-399-9144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-22772
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: