Staci Brickner
Individual provider Active NPI Pharmacist · Tiffin, OH
NPI 1013552603 · NPPES record last updated Nov 7, 2019
Key facts
- NPI
- 1013552603
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03328500 (OH)
- Practice address
- 1344 W Seneca Ave
Tiffin, OH 44883-2652 - Phone
- (567) 938-0300
- NPI assigned
- Nov 7, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03328500 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03328500 | OH | Yes |
Addresses
Primary practice location
1344 W Seneca Ave
Tiffin, OH 44883-2652
Mailing address
1344 W Seneca Ave
Tiffin, OH 44883-2652
Phone (567) 938-0300
Other providers in Tiffin, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.