Provider Demographics
NPI:1023469418
Name:FURDICH, KENNETH (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:FURDICH
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 1:3786 BILTZ RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6708
Mailing Address - Country:US
Mailing Address - Phone:800-686-2511
Mailing Address - Fax:
Practice Address - Street 1:1400 S ARLINGTON ST
Practice Address - Street 2:UNIT 38
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44306-3750
Practice Address - Country:US
Practice Address - Phone:330-724-5471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-27
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03136168183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist