Provider Demographics
NPI:1932224284
Name:DENNIS, CASEY M (RPH)
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:M
Last Name:DENNIS
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 1:1137 NORTHWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:OH
Mailing Address - Zip Code:43054-9057
Mailing Address - Country:US
Mailing Address - Phone:614-245-8078
Mailing Address - Fax:
Practice Address - Street 1:5151 BLAZER PKWY
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-3327
Practice Address - Country:US
Practice Address - Phone:800-346-1323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-24465183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist