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General NPI Number Information
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NPI Number | 1023603818
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Entity Type | Individual
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Provider Name | DEREK FROST PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 03/04/2021
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Last Update Date | 03/04/2021
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Provider Practice Location Address
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Address Line | 6847 N CHESTNUT ST
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City | RAVENNA
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State | OH
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Zip | 44266-3929
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Country | US
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Telephone | 330-297-8616
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Fax |
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Provider Business Mailing Address
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Address Line | 276 WILCOX RD
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City | AUSTINTOWN
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State | OH
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Zip | 44515-4277
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Country | US
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Telephone | 330-550-6483
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1835P1200X
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Taxonomy Name | Pharmacotherapy Pharmacist
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License Number | 03233884
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License Number State | OH
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