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General NPI Number Information
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NPI Number | 1518296235
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Entity Type | Organization
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Legal Business Name | STARK PRESCRIPTION ASSISTANCE NETWORK INC
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Dates
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Enumeration Date | 12/08/2009
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 408 9TH ST SW
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City | CANTON
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State | OH
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Zip | 44707-4714
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Country | US
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Telephone | 330-445-1085
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Fax |
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Provider Business Mailing Address
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Address Line | 408 9TH ST SW
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City | CANTON
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State | OH
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Zip | 44707-4714
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Country | US
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Telephone | 330-445-1085
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | KATHLEEN CATHER
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Credential |
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Telephone | 330-445-1085
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | CP02198230002
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License Number State | OH
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