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General NPI Number Information
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NPI Number | 1750307609
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Entity Type | Organization
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Legal Business Name | DENNYS PHARMACY
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Dates
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Enumeration Date | 07/14/2006
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Last Update Date | 07/10/2008
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Provider Practice Location Address
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Address Line | 30 S MAIN ST
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City | OTTERBEIN
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State | IN
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Zip | 47970-0482
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Country | US
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Telephone | 765-583-4395
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Fax | 765-884-8329
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Provider Business Mailing Address
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Address Line | PO BOX 482
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City | OTTERBEIN
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State | IN
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Zip | 47970-0482
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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 | OWNER
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Name | KENT STEMBEL
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Credential |
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Telephone | 765-583-4395
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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 | 60003935
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License Number State | IN
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