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General NPI Number Information
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NPI Number | 1447925961
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Entity Type | Individual
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Provider Name | GREG KIMMEL RPH
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Gender | Male
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Dates
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Enumeration Date | 08/16/2021
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Last Update Date | 08/16/2021
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Provider Practice Location Address
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Address Line | 12623 ECKEL JUNCTION RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-1304
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Country | US
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Telephone | 567-368-1434
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Fax | 567-368-1433
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Provider Business Mailing Address
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Address Line | 12623 ECKEL JUNCTION RD
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City | PERRYSBURG
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State | OH
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Zip | 43551-1304
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Country | US
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Telephone | 567-368-1434
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Fax | 567-368-1433
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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 | 1835P2201X
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Taxonomy Name | Ambulatory Care Pharmacist
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License Number | 03213821
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License Number State | OH
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