Provider Demographics
NPI:1992904031
Name:GHUSSIN, KINDY (RPH)
Entity type:Individual
Prefix:DR
First Name:KINDY
Middle Name:
Last Name:GHUSSIN
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 1:4421 ROOSEVELT BLVD
Mailing Address - Street 2:SUITE H
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45044-9023
Mailing Address - Country:US
Mailing Address - Phone:513-705-6252
Mailing Address - Fax:513-705-6253
Practice Address - Street 1:4421 ROOSEVELT BLVD
Practice Address - Street 2:SUITE H
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45044-9023
Practice Address - Country:US
Practice Address - Phone:513-705-6252
Practice Address - Fax:513-705-6253
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-25163183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist