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NPI Code Detail

MEDICARE: KEITH ANDREW KOVACS R.PH.

MEDICARE: KEITH ANDREW KOVACS R.PH.
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
1183500000XPharmacist19266OH

General Provider Information

NPI Number : 1922609387
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEITH ANDREW KOVACS R.PH.
Provider Business Mailing Address
First Line : 2485 POSSUM RUN RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-9447
Country : US
Telephone Number : 419-756-7177
Fax Number : 419-756-7205
Provider Business Practice Location Address
First Line : 2485 POSSUM RUN RD
Second Line :
City : MANSFIELD
State : OH
Zip : 44903-9447
Country : US
Telephone Number : 419-756-7177
Fax Number : 419-756-7205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2020
Last Update Date : 11/03/2020

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