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General NPI Number Information
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NPI Number | 1699977702
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Entity Type | Individual
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Provider Name | KENNETH D CRIST PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 06/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3620 COURT DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-6456
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Country | US
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Telephone | 740-453-7555
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Fax | 740-453-5445
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Provider Business Mailing Address
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Address Line | 555 S SAMUEL DR
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City | ZANESVILLE
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State | OH
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Zip | 43701-1522
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Country | US
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Telephone | 740-454-7983
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Fax | 740-454-8028
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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 | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 03-1-13585
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License Number State | OH
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