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General NPI Number Information
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NPI Number | 1295983468
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Entity Type | Individual
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Provider Name | ANTHONY RAY MENDENHALL
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Gender | Male
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Dates
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Enumeration Date | 08/30/2008
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Last Update Date | 08/30/2008
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Provider Practice Location Address
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Address Line | 14701 PEARL RD PHARMACY DEPARTMENT
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City | STRONGSVILLE
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State | OH
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Zip | 44136-5026
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Country | US
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Telephone | 440-572-0455
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Fax | 440-268-0982
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Provider Business Mailing Address
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Address Line | 13463 ROSEWOOD LN
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City | STRONGSVILLE
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State | OH
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Zip | 44136-2724
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Country | US
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Telephone | 440-846-6152
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-3-18272
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License Number State | OH
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