Provider Demographics
NPI:1275074874
Name:NISBETT, DENNIS (RPH)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:
Last Name:NISBETT
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 1:611 BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44502-1037
Mailing Address - Country:US
Mailing Address - Phone:330-743-0922
Mailing Address - Fax:330-743-0924
Practice Address - Street 1:611 BELMONT AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44502-1037
Practice Address - Country:US
Practice Address - Phone:330-743-0922
Practice Address - Fax:330-743-0924
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-15
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03314302183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist