Provider Demographics
NPI:1447997416
Name:KEMMERLING, COURTNEY P (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:COURTNEY
Middle Name:P
Last Name:KEMMERLING
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5350 LEAVITT RD
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44053-2158
Mailing Address - Country:US
Mailing Address - Phone:440-538-0110
Mailing Address - Fax:
Practice Address - Street 1:5350 LEAVITT RD
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2158
Practice Address - Country:US
Practice Address - Phone:440-538-0110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-19
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06016513183700000X
OH03442183183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No183700000XPharmacy Service ProvidersPharmacy Technician