Provider Demographics
NPI:1750043527
Name:DIMMICK, JOHN ALAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:ALAN
Last Name:DIMMICK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NORTON RD
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-1512
Mailing Address - Country:US
Mailing Address - Phone:330-650-4093
Mailing Address - Fax:
Practice Address - Street 1:1700 NORTON RD
Practice Address - Street 2:
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-1512
Practice Address - Country:US
Practice Address - Phone:330-650-4093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-09
Last Update Date:2021-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03335226183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist