Provider Demographics
NPI:1801311022
Name:VOLMER, GREG
Entity type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:VOLMER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11621 KETTERING DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45251-4618
Mailing Address - Country:US
Mailing Address - Phone:513-235-3168
Mailing Address - Fax:
Practice Address - Street 1:3050 MACK RD STE 330
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:OH
Practice Address - Zip Code:45014-5381
Practice Address - Country:US
Practice Address - Phone:513-557-7650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH100105360887409183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH100105360887409OtherPTCB