=====================================================
General NPI Number Information
=====================================================
NPI Number | 1548397284
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PATRICIA ANN TOMKO RPH
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/28/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 147 W LIBERTY ST
-----------------------------------------------------
City | HUBBARD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44425-1770
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-534-1907
-----------------------------------------------------
Fax | 330-534-8773
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5812 WATSON RD
-----------------------------------------------------
City | HUBBARD
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44425-1053
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 330-534-8966
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------