Active NPI
George Tackett, RPH
- Pharmacist
- Elyria, OH
National Provider Identifier
1699057398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 03223121
- Practice address
- 100 Cleveland St
Elyria, OH 44035-6138 - Phone
- (440) 322-7604
- NPI assigned
- Sep 19, 2011
- Sex
- Male
- 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 | 03223121 | OH | Primary |
Addresses
Primary practice location
100 Cleveland St
Elyria, OH 44035-6138
Mailing address
1008 Chippewa St
Grafton, OH 44044-1218
Phone (440) 452-4797
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03223121 | OH | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316390400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316390400000",
"number": "1699057398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1008 CHIPPEWA ST",
"city": "GRAFTON",
"state": "OH",
"postal_code": "440441218",
"telephone_number": "440-452-4797",
"fax_number": "440-322-9035"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 CLEVELAND ST",
"city": "ELYRIA",
"state": "OH",
"postal_code": "440356138",
"telephone_number": "440-322-7604"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "GEORGE",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-09-19",
"last_updated": "2011-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OH",
"license": "03223121",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elyria, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.