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General NPI Number Information
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NPI Number | 1487070363
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Entity Type | Individual
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Provider Name | GREGORY RICHARD KURTZ RPH
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Gender | Male
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Dates
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Enumeration Date | 03/14/2014
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 5200 HARROUN RD
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City | SYLVANIA
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State | OH
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Zip | 43560-2168
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Country | US
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Telephone | 419-824-1090
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Fax |
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Provider Business Mailing Address
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Address Line | 5403 OLDE POST RD
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City | SYLVANIA
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State | OH
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Zip | 43560-1111
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Country | US
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Telephone | 419-343-5418
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03317260
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302025992
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License Number State | MI
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