Provider Demographics
NPI:1265628002
Name:KAMM, GAYLE (PHARMD)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:
Last Name:KAMM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2801 W BANCROFT ST
Mailing Address - Street 2:MS #609
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3328
Mailing Address - Country:US
Mailing Address - Phone:419-530-2524
Mailing Address - Fax:419-530-1950
Practice Address - Street 1:3120 GLENDALE AVE
Practice Address - Street 2:RUPPERT HEALTH CENTER, ROOM 1600
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-5811
Practice Address - Country:US
Practice Address - Phone:419-383-4341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2007-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-19046183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist