Provider Demographics
NPI:1073758090
Name:KAMPER, JOAN T (RPH)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:T
Last Name:KAMPER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9225 LINDBERGH BLVD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-2407
Mailing Address - Country:US
Mailing Address - Phone:440-234-5659
Mailing Address - Fax:440-234-6443
Practice Address - Street 1:9225 LINDBERGH BLVD
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-2407
Practice Address - Country:US
Practice Address - Phone:440-234-5659
Practice Address - Fax:440-234-6443
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2008-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRPH.03107795183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03107795OtherSTATE BOARD OF PHARMACY