Active NPI
Kelly Prymicz, PHARMD
- Pharmacist
- Eastlake, OH
National Provider Identifier
1457640203
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03328762
- Practice address
- 34099 Melinz Pkwy
Eastlake, OH 44095-4041 - Phone
- (440) 953-0604
- Fax
- (440) 953-2494
- NPI assigned
- Apr 1, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 03328762 | OH | Primary |
Addresses
Primary practice location
34099 Melinz Pkwy
Eastlake, OH 44095-4041
Mailing address
34980 Eddy Rd
Willoughby Hills, OH 44094-9123
Phone (440) 278-4451
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03328762 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1301616000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1301616000000",
"number": "1457640203",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34980 EDDY RD",
"city": "WILLOUGHBY HILLS",
"state": "OH",
"postal_code": "440949123",
"telephone_number": "440-278-4451"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34099 MELINZ PKWY",
"city": "EASTLAKE",
"state": "OH",
"postal_code": "440954041",
"telephone_number": "440-953-0604",
"fax_number": "440-953-2494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRYMICZ",
"first_name": "KELLY",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-01",
"last_updated": "2011-04-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03328762",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eastlake, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.