Provider Demographics
NPI:1437375516
Name:KIMBLE, CRAIG ALLAN (PHARMD, MS, BCACP)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:ALLAN
Last Name:KIMBLE
Suffix:
Gender:M
Credentials:PHARMD, MS, BCACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 TOWNSHIP ROAD 1353
Mailing Address - Street 2:
Mailing Address - City:CROWN CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45623-8703
Mailing Address - Country:US
Mailing Address - Phone:740-451-0636
Mailing Address - Fax:
Practice Address - Street 1:MARSHALL UNIVERSITY SCHOOL OF PHARMACY
Practice Address - Street 2:ONE JOHN MARSHALL DRIVE, CEB 145
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25755-0001
Practice Address - Country:US
Practice Address - Phone:304-696-6014
Practice Address - Fax:304-696-7309
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2016-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH22891183500000X
KY0116811835P1200X
WV62751835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist