Kevin Pelter, PHARMD, RPH
Individual provider Active NPI Pharmacist · Sycamore, OH
NPI 1093386906 · NPPES record last updated Jul 2, 2021
Key facts
- NPI
- 1093386906
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03131801 (OH)
- Practice address
- 119 S Sycamore Avenue
Sycamore, OH 44882 - Phone
- (419) 927-2691
- NPI assigned
- Jul 2, 2021
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy, Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03131801 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fillmore Pharmacy LLC | Current |
Accepting new patients | |
| Donald C Fillmore | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03131801 | OH | Yes |
Addresses
Primary practice location
119 S Sycamore Avenue
Sycamore, OH 44882
Mailing address
PO Box 107
Sycamore, OH 44882-0107
Phone (419) 927-2691
Other providers in Sycamore, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 2, 2021. 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.