Organization
KMART PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG CLEMENS (PHARMACY DISTRCIT MANAGER)
(330) 544-3086
Entity
Organization
Contact information
Practice address
1284 BRICE RD, REYNOLDSBURG, OH 43068-2311
(614) 864-3636
Mailing address
1284 BRICE RD, REYNOLDSBURG, OH 43068-2311
(614) 864-3636
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
03132213
OH
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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