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General NPI Number Information
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NPI Number | 1740964386
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Entity Type | Individual
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Provider Name | EVET KOSTANDY
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Gender | Female
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Dates
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Enumeration Date | 06/14/2023
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Last Update Date | 06/14/2023
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Provider Practice Location Address
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Address Line | 9151 S OLD STATE RD
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City | LEWIS CENTER
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State | OH
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Zip | 43035-9496
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Country | US
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Telephone | 614-846-8027
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Fax |
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Provider Business Mailing Address
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Address Line | 5532 ROYAL POINTE DR
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City | DUBLIN
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State | OH
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Zip | 43016-7517
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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 | 03443015
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License Number State | OH
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