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General NPI Number Information
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NPI Number | 1811041486
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Entity Type | Individual
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Provider Name | MAX JOHN PEOPLES JR. R.PH.
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 23 N STATE ST
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City | WESTERVILLE
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State | OH
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Zip | 43081-2113
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Country | US
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Telephone | 614-882-2392
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Fax | 614-882-2399
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Provider Business Mailing Address
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Address Line | 2478 LACKEY OLD STATE RD
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City | DELAWARE
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State | OH
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Zip | 43015-9620
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Country | US
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Telephone | 740-548-1708
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Fax | 740-548-1745
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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 | 03-2-15247
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License Number State | OH
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