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General NPI Number Information
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NPI Number | 1649792110
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Entity Type | Individual
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Provider Name | JONATHAN ROBERT ALLEN PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 07/17/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 733 W MARKET ST
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City | TIFFIN
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State | OH
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Zip | 44883-2520
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Country | US
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Telephone | 419-455-9071
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Fax |
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Provider Business Mailing Address
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Address Line | 1060 HILARY LN APT H
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City | FINDLAY
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State | OH
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Zip | 45840-7652
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Country | US
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Telephone |
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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 | 03136284
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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 | 061250
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License Number State | NY
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