Organization
GREENS PHARMACY INC
Active
Other names
GREENS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT DODGE BSPH (PRESIDENT/PHARMACIST)
(419) 732-3151
Entity
Organization
Contact information
Practice address
200 MADISON ST, PORT CLINTON, OH 43452-1947
(419) 732-3151
(419) 734-6338
Mailing address
PO BOX 38, PORT CLINTON, OH 43452-0038
(419) 732-3151
(419) 734-6338
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
RTP.021068650-03
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2059463
—
OH
01
—
2072871
PK
—
Enumeration date
11/01/2005
Last updated
12/07/2018
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