Provider Demographics
NPI:1528724382
Name:GEYER, KRISTEL (PHARMD BCPS BCOP)
Entity type:Individual
Prefix:
First Name:KRISTEL
Middle Name:
Last Name:GEYER
Suffix:
Gender:F
Credentials:PHARMD BCPS BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12863 KINGSTON WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH ROYALTON
Mailing Address - State:OH
Mailing Address - Zip Code:44133-5993
Mailing Address - Country:US
Mailing Address - Phone:414-622-6286
Mailing Address - Fax:
Practice Address - Street 1:9500 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-0002
Practice Address - Country:US
Practice Address - Phone:216-448-7732
Practice Address - Fax:216-448-5601
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-16
Last Update Date:2021-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03236702183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist