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General NPI Number Information
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NPI Number | 1760690986
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Entity Type | Organization
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Legal Business Name | CEUTICARE
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7619 OLYMPIC PKWY
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City | SYLVANIA
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State | OH
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Zip | 43560-4309
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Country | US
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Telephone | 614-506-8128
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Fax |
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Provider Business Mailing Address
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Address Line | 7619 OLYMPIC PKWY
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City | SYLVANIA
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State | OH
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Zip | 43560-4309
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Country | US
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Telephone | 614-506-8128
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | DR. ALLEN NICHOL
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Credential | PHARM.D.
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Telephone | 614-506-8128
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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 | 03-1-10924
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License Number State | OH
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