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General NPI Number Information
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NPI Number | 1538496575
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Entity Type | Organization
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Legal Business Name | FIELDS MINI-MEDICAL CLINIC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 11/12/2009
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Provider Practice Location Address
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Address Line | 415 S MAIN ST
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City | WAYNESVILLE
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State | OH
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Zip | 45068-9553
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Country | US
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Telephone | 513-897-7076
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Fax | 513-897-1446
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Provider Business Mailing Address
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Address Line | 415 S MAIN ST
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City | WAYNESVILLE
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State | OH
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Zip | 45068-9553
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Country | US
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Telephone | 513-897-7076
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Fax | 513-897-1446
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Authorized Official
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Title or Position | CLINICAL PHARMACIST
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Name | DR. KATHERINE VAUGHN FIELDS
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Credential | PHARMD
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Telephone | 513-897-7076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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