Healthcare Provider Details

I. General information

NPI: 1326956087
Provider Name (Legal Business Name): IAN WARD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4209 STATE ROUTE 44
ROOTSTOWN OH
44272-9698
US

IV. Provider business mailing address

4209 STATE ROUTE 44
ROOTSTOWN OH
44272-9698
US

V. Phone/Fax

Practice location:
  • Phone: 800-686-2511
  • Fax:
Mailing address:
  • Phone: 800-686-2511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number060004452
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: