Organization
MIKE TELL CHAR INC
Active
Other names
Bassett's Market
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE GERBER RPH (PHARMACIST, AO)
(419) 732-6300
Entity
Organization
Contact information
Practice address
3994 E HARBOR RD, PORT CLINTON, OH 43452-2671
(419) 732-6300
(419) 734-4063
Mailing address
3994 E HARBOR RD, PORT CLINTON, OH 43452-2671
(419) 732-6300
(419) 734-4063
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
020587300
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0739491
—
OH
01
—
2071108
PK
—
Enumeration date
08/18/2006
Last updated
08/02/2019
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