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General NPI Number Information
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NPI Number | 1154517878
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Entity Type | Organization
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Legal Business Name | OHIO VETERANS HOME PHARMACY-GEORGETOWN
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Dates
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Enumeration Date | 09/17/2007
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Last Update Date | 01/18/2017
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Provider Practice Location Address
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Address Line | 7110 BACHMAN RD
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City | SARDINIA
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State | OH
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Zip | 45171-9456
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Country | US
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Telephone | 800-284-8741
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Fax | 937-446-2600
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Provider Business Mailing Address
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Address Line | 7110 BACHMAN RD
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City | SARDINIA
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State | OH
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Zip | 45171-9456
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Country | US
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Telephone | 800-284-8741
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Fax | 937-446-2600
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Authorized Official
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Title or Position | PHARMACY OPERATIONS MANAGER
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Name | RANDALL HARRIS
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Credential | RPH
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Telephone | 419-625-2454
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 021416750
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License Number State | OH
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