Healthcare Provider Details

I. General information

NPI: 1285646489
Provider Name (Legal Business Name): MARIA R MASCIO RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 KARL RD
COLUMBUS OH
43229-3604
US

IV. Provider business mailing address

1558 CLUBVIEW BLVD S
COLUMBUS OH
43235-1636
US

V. Phone/Fax

Practice location:
  • Phone: 614-847-3784
  • Fax: 614-847-6171
Mailing address:
  • Phone: 614-847-3784
  • Fax: 614-847-6171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-12458
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: