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General NPI Number Information
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NPI Number | 1720061591
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Entity Type | Organization
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Legal Business Name | NEIDIG HEALTH CARE, LTD
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Dates
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Enumeration Date | 11/24/2005
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 710 BOULEVARD ST
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City | DOVER
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State | OH
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Zip | 44622-2006
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Country | US
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Telephone | 330-602-9473
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Fax | 330-343-2442
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Provider Business Mailing Address
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Address Line | PO BOX 1023
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City | NEW PHILADELPHIA
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State | OH
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Zip | 44663-5123
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Country | US
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Telephone | 330-602-9473
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Fax | 330-343-2442
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Authorized Official
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Title or Position | MEMBER
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Name | MR. JEFFREY A NEIDIG
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Credential | RPH
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Telephone | 330-602-9473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 02-1523450
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License Number State | OH
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