Provider Demographics
NPI:1760690986
Name:CEUTICARE
Entity Type:Organization
Organization Name:CEUTICARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:614-506-8128
Mailing Address - Street 1:7619 OLYMPIC PKWY
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-4309
Mailing Address - Country:US
Mailing Address - Phone:614-506-8128
Mailing Address - Fax:
Practice Address - Street 1:7619 OLYMPIC PKWY
Practice Address - Street 2:
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-4309
Practice Address - Country:US
Practice Address - Phone:614-506-8128
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-109241835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapyGroup - Single Specialty