BRUCE ALLEN PETKOVSEK (NPI# 1386913044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386913044 |
| Entity Type | Individual |
| Full Name | BRUCE ALLEN PETKOVSEK |
| Credential | RPH |
| Practice Address |
3600 Kolbe Rd Lorain OH 44053-1654 |
| Practice Telephone | 4409603420 |
| Practice Fax Number | 4409603908 |
| Mailing Telephone | 4409603420 |
| Mailing Fax Number | 4409603908 |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2011-12-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 03113613 | OH | Pharmacy Service Providers |
| Street Address |
3600 KOLBE RD |
| City | LORAIN |
| State | OH |
| Zip Code | 44053-1654 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396749370 | Khalid Akbar | Pediatrics | 3600 Kolbe Rd, Ste 105, Lorain, OH 44053-1654 | 2005-06-08 |
| 1558899237 | Ellen Marie Kelly | Physician Assistant | 3600 Kolbe Rd, Lorain, OH 44053-1654 | 2017-05-25 |
| 1225579113 | University Primary Care Practices, Inc. | Orthopaedic Surgery | 3600 Kolbe Rd, Ste 100, Lorain, OH 44053-1654 | 2017-03-13 |
| 1275997553 | Roman A Ringel Md Inc | Surgery | 3600 Kolbe Rd, Ste 222, Lorain, OH 44053-1654 | 2016-04-12 |
| 1609257005 | Kelly Norris | Nurse Practitioner | 3600 Kolbe Rd, Suite 209, Lorain, OH 44053-1654 | 2015-06-11 |
| 1265848089 | Mccarty Family Foot & Ankle | Podiatrist | 3600 Kolbe Rd, Lorain, OH 44053-1654 | 2014-07-02 |
| 1770906216 | Center for Orthopedics, Inc | Durable Medical Equipment & Medical Supplies | 3600 Kolbe Rd, Suite 100, Lorain, OH 44053-1654 | 2014-02-03 |
| 1316375959 | Dawn Gibson-owens | Nurse Practitioner | 3600 Kolbe Rd, Suite 227, Lorain, OH 44053-1654 | 2013-10-16 |
| 1043558273 | Womens Professional Services Corp | Obstetrics & Gynecology | 3600 Kolbe Rd, 210, Lorain, OH 44053-1654 | 2013-01-23 |
| 1174878490 | Ryan M Shick | Pharmacist | 3600 Kolbe Rd, Suite 108, Lorain, OH 44053-1654 | 2012-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242196 | Yokita Maria Thomas | Homemaker | 4818 Ashland Ave, Lordin, OH 44053 | 2020-10-14 |
| 1497353445 | Matthew George Simkovich | Homemaker | 4366 Jenee Dr, Lorain, OH 44053 | 2020-10-13 |
| 1881229979 | Christine Wilson | Physical Therapist | 5940 Oak Point Rd., Lorain, Lorain, OH 44053 | 2020-03-09 |
| 1912538760 | Barry Delaney Masin | Student in an Organized Health Care Education/Training Program | 2704 West Erie Avenue, Lorain, OH 44053 | 2020-01-30 |
| 1275171399 | Martina Beato | Social Worker | The Nord Center 6140 S. Broadway, Lorain, OH 44053 | 2019-12-19 |
| 1285279802 | Tivan LLC | Non-emergency Medical Transport (VAN) | 5821 Williamsburg Dr., Lorain, OH 44053 | 2019-11-07 |
| 1023650843 | Candace Taber | Case Manager/Care Coordinator | 6140 South Broadway, Lorain, OH 44053 | 2019-10-14 |
| 1265956098 | Phillip H Emerson | Social Worker | 1740 Cooper Foster Park Road East, Lorain, OH 44053 | 2017-08-02 |
| 1447796750 | Kafilat Idowu Kelani | Nurse Practitioner | 3700 Kolbe Rd, Lorain, Lorain, OH 44053 | 2017-01-10 |
| 1083075808 | Mark B Applegate | Counselor | 2115 West Park Drive, Lorain, OH 44053 | 2016-03-08 |
| Find all providers in zip 44053 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598056913 | Steven Arthur Lindsey Sr. | Pharmacist | 2709 Broadway, Lorain, OH 44052-4835 | 2011-04-20 |
| 1063715233 | Benny Yiu | Pharmacist | 3711 S Hogan Dr, Lorain, OH 44053-1416 | 2010-12-09 |
| 1578886370 | Jeffrey Shirkey | Pharmacist | 5350 Leavitt Rd, Lorain, OH 44053-2158 | 2010-03-08 |
| 1831396746 | Guardian Health Enterprises | Pharmacist | 400 Sheffield Ctr, Pharmacy, Lorain, OH 44055-3158 | 2007-07-03 |
| 1780895144 | Ashley Jo Kenzik | Pharmacist | 2853 Grove Ave, Lorain, OH 44055-2041 | 2007-05-25 |
| 1154949675 | Alexis Michelle Nieszczur | Pharmacist | 5350 Leavitt Rd, Lorain, OH 44053-2158 | 2020-07-10 |
| 1285110270 | Mackenzie Hrubey | Pharmacist | 3700 Kolbe Rd, Lorain, OH 44053-1611 | 2018-07-13 |
| 1033637335 | Kaitlyn Marie Knick | Pharmacist | 3700 Kolbe Rd, Lorain, OH 44053-1611 | 2017-09-07 |
| 1104344910 | Joshua Andrew Harold | Pharmacist | 3700 Kolbe Rd., Lorain, OH 44053 | 2017-08-31 |
| 1144746124 | Serena M Lamping | Pharmacist | 3700 Kolbe Rd, Lorain, OH 44053-1611 | 2017-08-21 |
| Find all providers in LORAIN | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.