Dennis Radecki, RPH
Individual provider Active NPI Pharmacist · Northwood, OH
NPI 1316246804 · NPPES record last updated Mar 23, 2011
Key facts
- NPI
- 1316246804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03114721 (OH)
- Practice address
- 2647 Woodville Rd
Northwood, OH 43619 - Phone
- (419) 693-1310
- NPI assigned
- Mar 23, 2011
- Sex
- Male
- 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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03114721 | OH | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03114721 | OH | Yes |
Addresses
Primary practice location
2647 Woodville Rd
Northwood, OH 43619
Mailing address
4252 Deer Run
Oregon, OH 43616-3580
Phone (419) 697-1154
Other providers in Northwood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 23, 2011. 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.