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General NPI Number Information
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NPI Number | 1952745481
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Entity Type | Individual
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Provider Name | JACOB PHILIP-REID DEITSCH PHARM.D., BCPS
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Gender | Male
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Dates
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Enumeration Date | 04/26/2013
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Last Update Date | 03/07/2019
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Provider Practice Location Address
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Address Line | 2182 DIVIDEND DR
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City | COLUMBUS
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State | OH
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Zip | 43228
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Country | US
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Telephone | 844-386-2472
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Fax | 888-776-5018
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Provider Business Mailing Address
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Address Line | 15529 COLLEGE BLVD
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City | LENEXA
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State | KS
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Zip | 66219-1351
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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 | 020469
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License Number State | KY
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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 | 03233825
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License Number State | OH
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