Provider Demographics
NPI:1215168240
Name:NITZSCHKE, MARC (RPH)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:NITZSCHKE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 SALISBURY DR
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8383
Mailing Address - Country:US
Mailing Address - Phone:614-787-8210
Mailing Address - Fax:
Practice Address - Street 1:460 SALISBURY DR
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8383
Practice Address - Country:US
Practice Address - Phone:614-787-8210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-08
Last Update Date:2009-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-23539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist