Provider Demographics
NPI:1043854920
Name:KORBAS, KURT (PHARMD)
Entity Type:Individual
Prefix:
First Name:KURT
Middle Name:
Last Name:KORBAS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 W STERLING RD
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:OH
Mailing Address - Zip Code:44214-9451
Mailing Address - Country:US
Mailing Address - Phone:419-631-1687
Mailing Address - Fax:
Practice Address - Street 1:1996 E MAIN ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OH
Practice Address - Zip Code:44805-8944
Practice Address - Country:US
Practice Address - Phone:419-289-6859
Practice Address - Fax:419-289-0831
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03331253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist