Provider Demographics
NPI:1073809836
Name:KACSMAR, MICHAEL E (RPH)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:E
Last Name:KACSMAR
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 HIGHWAY 7 S
Mailing Address - Street 2:
Mailing Address - City:POWHATAN POINT
Mailing Address - State:OH
Mailing Address - Zip Code:43942-1143
Mailing Address - Country:US
Mailing Address - Phone:740-795-4837
Mailing Address - Fax:
Practice Address - Street 1:63 HIGHWAY 7 S
Practice Address - Street 2:
Practice Address - City:POWHATAN POINT
Practice Address - State:OH
Practice Address - Zip Code:43942-1143
Practice Address - Country:US
Practice Address - Phone:740-795-4837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-21903183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist