Healthcare Provider Details

I. General information

NPI: 1003412032
Provider Name (Legal Business Name): DAVID JOSEPH VRABLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2020
Last Update Date: 12/06/2020
Certification Date: 12/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6165 GLICK RD
POWELL OH
43065-9468
US

IV. Provider business mailing address

6165 GLICK RD
POWELL OH
43065-9468
US

V. Phone/Fax

Practice location:
  • Phone: 614-766-8399
  • Fax: 614-766-5795
Mailing address:
  • Phone: 614-766-8399
  • Fax: 614-766-5795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03325509
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: