Provider Demographics
NPI:1760495626
Name:KUNKEL PHARMACUTICALS INC.
Entity Type:Organization
Organization Name:KUNKEL PHARMACUTICALS INC.
Other - Org Name:KUNKEL MEDICAL & PHARMACY
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:DINKELAKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:513-231-1943
Mailing Address - Street 1:7717 BEECHMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-4203
Mailing Address - Country:US
Mailing Address - Phone:513-231-1943
Mailing Address - Fax:513-231-1442
Practice Address - Street 1:7717 BEECHMONT AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45255-4203
Practice Address - Country:US
Practice Address - Phone:513-231-1943
Practice Address - Fax:513-231-1442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH31195381332B00000X
OH0205066503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0408731Medicaid
OH3613254OtherNABP
OH0408731Medicaid
OH3613254OtherNABP