Organization
KLASS APOTHECARY INC
Active
Other names
TUCKERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROY KLASS BS RPH (OWNER)
(937) 477-9653
Entity
Organization
Contact information
Practice address
105 DR THATYE DRIVE, GLANDORF, OH 45848
(419) 538-7120
(419) 538-7121
Mailing address
PO BOX 33, GLANDORF, OH 45848-0033
(419) 538-7120
(419) 538-7121
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
021756150
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2781306
—
OH
01
—
3669314
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/15/2006
Last updated
02/11/2011
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