Healthcare Provider Details

I. General information

NPI: 1245165968
Provider Name (Legal Business Name): ANDREW BURTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3825 FISHCREEK RD
STOW OH
44224-4322
US

IV. Provider business mailing address

3825 FISHCREEK RD STE 160
STOW OH
44224-4394
US

V. Phone/Fax

Practice location:
  • Phone: 234-867-6496
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835X0200X
TaxonomyOncology Pharmacist
License Number03444406
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: