Healthcare Provider Details

I. General information

NPI: 1619643970
Provider Name (Legal Business Name): DANIEL ALLEN SEVARNS RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2021
Last Update Date: 08/17/2021
Certification Date: 08/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7800 CLEVELAND AVE NW
NORTH CANTON OH
44720-5658
US

IV. Provider business mailing address

1302 CAROL DR
KENT OH
44240-1603
US

V. Phone/Fax

Practice location:
  • Phone: 330-499-3448
  • Fax:
Mailing address:
  • Phone: 573-337-0772
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03441063
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: