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NPI Code Detail

MEDICARE: ANTHONY EBERLY COTAL

MEDICARE: ANTHONY EBERLY COTAL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH.03331431OH
2224Z00000XOccupational Therapy Assistant03102OH

General Provider Information

NPI Number : 1699978635
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANTHONY EBERLY COTAL
Provider Business Mailing Address
First Line : 2386 SUNLADEN DR
Second Line :
City : GROVE CITY
State : OH
Zip : 43123-1585
Country : US
Telephone Number : 614-539-4482
Fax Number :
Provider Business Practice Location Address
First Line : 9110 DUBLIN RD
Second Line :
City : POWELL
State : OH
Zip : 43065-9588
Country : US
Telephone Number : 614-932-0303
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2007
Last Update Date : 12/23/2011

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