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General NPI Number Information
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NPI Number | 1558962480
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Entity Type | Individual
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Provider Name | TIFFANY MARIE RICO X PHARMD
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Gender | Female
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 2850 MAPLE AVE
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City | ZANESVILLE
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State | OH
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Zip | 43701-1754
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Country | US
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Telephone | 740-455-9007
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Fax | 740-455-9015
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Provider Business Mailing Address
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Address Line | 6680 WILSON LN
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City | NASHPORT
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State | OH
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Zip | 43830-9141
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Country | US
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Telephone | 740-310-2763
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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 | 30439
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License Number State | OH
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