Healthcare Provider Details

I. General information

NPI: 1710999586
Provider Name (Legal Business Name): GAHM'S PHARMACY II, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2006
Last Update Date: 02/25/2020
Certification Date: 02/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1565 GALENA PIKE
WEST PORTSMOUTH OH
45663-6059
US

IV. Provider business mailing address

1565 GALENA PIKE
WEST PORTSMOUTH OH
45663-6059
US

V. Phone/Fax

Practice location:
  • Phone: 740-858-5000
  • Fax: 740-858-9177
Mailing address:
  • Phone: 740-858-5000
  • Fax: 740-858-9177

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number02-1228850
License Number StateOH

VIII. Authorized Official

Name: MR. KEVIN M GAHM
Title or Position: PRESIDENT
Credential: RPH
Phone: 740-858-5000