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General NPI Number Information
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NPI Number | 1427109206
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Entity Type | Organization
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Legal Business Name | CONKLING'S PHARMACY
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 112 EAST MAIN STREET
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City | PANDORA
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State | OH
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Zip | 45877
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Country | US
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Telephone | 419-384-3303
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Fax | 419-384-3308
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Provider Business Mailing Address
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Address Line | PO BOX 296
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City | PANDORA
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State | OH
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Zip | 45877-0296
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Country | US
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Telephone | 419-384-3303
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Fax | 419-384-3308
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Authorized Official
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Title or Position | OWNER
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Name | GREG CONKLING
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Credential | RPH
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Telephone | 419-384-3303
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 02-0851200
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License Number State | OH
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