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General NPI Number Information
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NPI Number | 1457605313
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Entity Type | Individual
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Provider Name | SAMUEL HOWARD JOHNSON PHARMD
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Gender | Male
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Dates
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Enumeration Date | 10/31/2012
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Last Update Date | 10/31/2012
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Provider Practice Location Address
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Address Line | 335 MAIN ST
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City | GREENVILLE
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State | PA
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Zip | 16125-2614
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Country | US
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Telephone | 724-588-3398
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Fax |
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Provider Business Mailing Address
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Address Line | 10651 CUTTER RD
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City | MEADVILLE
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State | PA
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Zip | 16335-6531
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Country | US
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Telephone | 814-547-3663
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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 | RP447140
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License Number State | PA
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