Healthcare Provider Details

I. General information

NPI: 1982304333
Provider Name (Legal Business Name): ROSE FOLTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2023
Last Update Date: 03/06/2023
Certification Date: 03/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 N WILLIAMS ST
PAULDING OH
45879-1076
US

IV. Provider business mailing address

1000 N WILLIAMS ST
PAULDING OH
45879-1076
US

V. Phone/Fax

Practice location:
  • Phone: 419-399-5348
  • Fax:
Mailing address:
  • Phone: 419-399-5348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number09216304
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: