Provider Demographics
NPI:1386164796
Name:MYERS, JOHN CHRISTIAN (PHARMD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CHRISTIAN
Last Name:MYERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5120 COUNTY ROAD 231
Mailing Address - Street 2:
Mailing Address - City:CLYDE
Mailing Address - State:OH
Mailing Address - Zip Code:43410-9745
Mailing Address - Country:US
Mailing Address - Phone:419-239-3960
Mailing Address - Fax:
Practice Address - Street 1:226 E PERKINS AVE
Practice Address - Street 2:
Practice Address - City:SANDUSKY
Practice Address - State:OH
Practice Address - Zip Code:44870-4905
Practice Address - Country:US
Practice Address - Phone:419-239-2624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2017-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03232877183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist