Healthcare Provider Details

I. General information

NPI: 1063869725
Provider Name (Legal Business Name): KAMMI HUMED
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2016
Last Update Date: 05/12/2022
Certification Date: 05/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 HILL RD N
PICKERINGTON OH
43147-8887
US

IV. Provider business mailing address

4685 E GRANT RD 102
TUCSON AZ
85712-2618
US

V. Phone/Fax

Practice location:
  • Phone: 614-751-1736
  • Fax:
Mailing address:
  • Phone: 520-326-4341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03440320
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberS022264
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: