Organization
KLASS APOTHECARY INC
Active
Other names
TUCKERS OTTAWA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ROY KLASS BS,RPH (OWNER,PIC,AO)
(937) 477-9653
Entity
Organization
Contact information
Practice address
1831 E MAIN ST, OTTAWA, OH 45875-1649
(419) 523-6122
(419) 523-6228
Mailing address
1831 E MAIN ST, OTTAWA, OH 45875-1649
(419) 523-6122
(419) 523-6228
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
021756100
OH
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2075405
PK
—
05
—
2780987
—
OH
Enumeration date
03/14/2006
Last updated
12/16/2016
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