Organization
CHURCHILLS PERRYSBURG LTD
Active
Other names
Walt Churchill's Market
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY JOHNSON RPH (PHARMACY MANAGER,PIC,AO)
(419) 872-6904
Entity
Organization
Contact information
Practice address
26625 DIXIE HWY, PERRYSBURG, OH 43551-1712
(419) 872-6904
(419) 872-6917
Mailing address
26625 DIXIE HWY, PERRYSBURG, OH 43551-1712
(419) 872-6904
(419) 872-6917
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021949950
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051914
—
OH
01
—
2119661
PK
—
Enumeration date
12/18/2006
Last updated
01/18/2017
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