Provider Demographics
NPI:1477151801
Name:INBODY, PEGGY MARIE
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:MARIE
Last Name:INBODY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 STATE ROUTE 224
Mailing Address - Street 2:
Mailing Address - City:MC COMB
Mailing Address - State:OH
Mailing Address - Zip Code:45858-9785
Mailing Address - Country:US
Mailing Address - Phone:513-377-8556
Mailing Address - Fax:
Practice Address - Street 1:2100 MICHIGAN ST
Practice Address - Street 2:
Practice Address - City:SIDNEY
Practice Address - State:OH
Practice Address - Zip Code:45365-9005
Practice Address - Country:US
Practice Address - Phone:937-498-4116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-16
Last Update Date:2020-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH034386391835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist