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General NPI Number Information
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NPI Number | 1265287742
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Entity Type | Individual
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Provider Name | BACIL KADI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/18/2024
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Last Update Date | 04/18/2024
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Provider Practice Location Address
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Address Line | 410 W 10TH AVE
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City | COLUMBUS
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State | OH
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Zip | 43210-1240
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Country | US
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Telephone | 574-340-8893
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 HAMPTON RIVERS RD UNIT 205
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City | CHARLESTON
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State | SC
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Zip | 29414-9300
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Country | US
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Telephone | 574-340-8893
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835E0208X
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Taxonomy Name | Emergency Medicine Pharmacist
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License Number | 43940
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License Number State | SC
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