Provider Demographics
NPI:1427355767
Name:INJURY MED EXPRESS
Entity type:Organization
Organization Name:INJURY MED EXPRESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:JON
Authorized Official - Middle Name:R
Authorized Official - Last Name:KEELEY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:855-729-3939
Mailing Address - Street 1:6920 HALL ST
Mailing Address - Street 2:SUITE #2
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-9485
Mailing Address - Country:US
Mailing Address - Phone:855-729-3939
Mailing Address - Fax:855-879-4949
Practice Address - Street 1:6920 HALL ST
Practice Address - Street 2:SUITE #2
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528-9485
Practice Address - Country:US
Practice Address - Phone:855-729-3939
Practice Address - Fax:855-879-4949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-02-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0221056503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy