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NPI Code Detail

MEDICARE: CASEY ELIZABETH KOESTER PHARMD

MEDICARE: CASEY ELIZABETH KOESTER PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist26027463AIN
2183500000XPharmacist03237172OH

General Provider Information

NPI Number : 1164065561
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASEY ELIZABETH KOESTER PHARMD
Provider Business Mailing Address
First Line : 306 E COLLEGE ST
Second Line :
City : COLDWATER
State : OH
Zip : 45828-1825
Country : US
Telephone Number : 567-644-4848
Fax Number :
Provider Business Practice Location Address
First Line : 102 N WAYNE ST
Second Line :
City : FORT RECOVERY
State : OH
Zip : 45846-8059
Country : US
Telephone Number : 419-375-2323
Fax Number : 419-375-4488
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2019
Last Update Date : 10/18/2019

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