Organization
IHS PHARMACY & WELLNESS CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TODD ALLEN TACKAGE (PHARMACY MANAGER)
(740) 572-1561
Entity
Organization
Contact information
Practice address
4940 COTTONVILLE RD, JAMESTOWN, OH 45335-1522
(937) 675-6500
(937) 675-6540
Mailing address
4940 COTTONVILLE RD, JAMESTOWN, OH 45335-1522
(937) 675-6500
(937) 675-6540
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
022075950
OH
Other
Enumeration date
09/15/2010
Last updated
09/28/2010
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