Provider Demographics
NPI:1811041486
Name:PEOPLES, MAX JOHN JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:MAX
Middle Name:JOHN
Last Name:PEOPLES
Suffix:JR
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2478 LACKEY OLD STATE RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-9620
Mailing Address - Country:US
Mailing Address - Phone:740-548-1708
Mailing Address - Fax:740-548-1745
Practice Address - Street 1:23 N STATE ST
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-2113
Practice Address - Country:US
Practice Address - Phone:614-882-2392
Practice Address - Fax:614-882-2399
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-15247183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist