Provider Demographics
NPI:1265101372
Name:KUREK, TODD MATTHEW (RPH)
Entity type:Individual
Prefix:MR
First Name:TODD
Middle Name:MATTHEW
Last Name:KUREK
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 1:8111 SUMMERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49270-9739
Mailing Address - Country:US
Mailing Address - Phone:419-973-3255
Mailing Address - Fax:
Practice Address - Street 1:7504 W CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43617-1524
Practice Address - Country:US
Practice Address - Phone:419-973-3255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03215620183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist