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General NPI Number Information
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NPI Number | 1841615382
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Entity Type | Individual
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Provider Name | JOSEPH DANIEL BACK JR. PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 02/20/2014
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Last Update Date | 02/20/2014
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Provider Practice Location Address
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Address Line | 1000 SPRUCE GLN
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City | MORROW
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State | OH
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Zip | 45152-7942
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Country | US
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Telephone | 513-238-3131
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 SPRUCE GLN
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City | MORROW
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State | OH
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Zip | 45152-7942
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Country | US
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Telephone | 513-238-3131
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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 | 03228210
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 013851
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License Number State | KY
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