Healthcare Provider Details

I. General information

NPI: 1548590789
Provider Name (Legal Business Name): ALVIN JOHN HOMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 01/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8264 W STATE ROUTE 41
COVINGTON OH
45318-1248
US

IV. Provider business mailing address

172 S GARFIELD ST
MINSTER OH
45865-1318
US

V. Phone/Fax

Practice location:
  • Phone: 937-473-3333
  • Fax: 937-473-3000
Mailing address:
  • Phone: 419-628-3198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03211249
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: