Healthcare Provider Details

I. General information

NPI: 1437375516
Provider Name (Legal Business Name): CRAIG ALLAN KIMBLE PHARMD, MS, BCACP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 05/18/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MARSHALL UNIVERSITY SCHOOL OF PHARMACY ONE JOHN MARSHALL DRIVE, CEB 145
HUNTINGTON WV
25755-0001
US

IV. Provider business mailing address

152 TOWNSHIP ROAD 1353
CROWN CITY OH
45623-8703
US

V. Phone/Fax

Practice location:
  • Phone: 304-696-6014
  • Fax: 304-696-7309
Mailing address:
  • Phone: 740-451-0636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number22891
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number011681
License Number StateKY
# 3
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number6275
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: