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General NPI Number Information
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NPI Number | 1497277636
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Entity Type | Individual
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Provider Name | ADAM PLANK
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Gender | Male
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Dates
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Enumeration Date | 07/10/2017
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Last Update Date | 07/10/2017
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Provider Practice Location Address
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Address Line | 7150 EXECUTIVE BLVD
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City | HUBER HEIGHTS
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State | OH
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Zip | 45424-1412
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Country | US
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Telephone | 937-237-4610
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Fax |
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Provider Business Mailing Address
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Address Line | 5341 HOOVER RD
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City | GROVE CITY
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State | OH
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Zip | 43123-9119
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Country | US
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Telephone | 614-561-5391
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | 03236898
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License Number State | OH
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