Provider Demographics
NPI:1922346667
Name:KIFFMEYER, JAMES G (RPH)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:G
Last Name:KIFFMEYER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 GRAND AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45205-2805
Mailing Address - Country:US
Mailing Address - Phone:513-921-4436
Mailing Address - Fax:
Practice Address - Street 1:5275 WINNESTE AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45232-1130
Practice Address - Country:US
Practice Address - Phone:513-242-5700
Practice Address - Fax:513-482-5461
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-30
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03213819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist