Organization
OVERHOLTS CHAMPION PHARMACY INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH MARSHALL OVERHOLT JR. RPH (PRESIDENT/CHIEF PHARMACIST)
(330) 847-8000
Entity
Organization
Contact information
Practice address
4619 MAHONING AVE., WARREN, OH 44483
(330) 847-8000
(330) 847-7708
Mailing address
4619 MAHONING AVE., WARREN, OH 44483
(330) 847-8000
(330) 847-7708
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02649200
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0827118
—
OH
Enumeration date
10/03/2006
Last updated
08/22/2020
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