Traci Lynn Deckling, RPH
Individual provider Active NPI Pharmacist · Ada, OH
NPI 1447760343 · NPPES record last updated Oct 5, 2017
Key facts
- NPI
- 1447760343
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 03319901 (OH)
- Practice address
- 610 S Main St
Ada, OH 45810-1503 - Phone
- (419) 634-0888
- NPI assigned
- Oct 5, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
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 |
|---|---|---|---|
| 03319901 | OH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rite Aid of Ohio Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03319901 | OH | Yes |
Addresses
Primary practice location
610 S Main St
Ada, OH 45810-1503
Mailing address
3237 County Road 135
Dola, OH 45835-9733
Other providers in Ada, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 5, 2017. 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.