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General NPI Number Information
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NPI Number | 1619186483
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Entity Type | Organization
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Legal Business Name | ROSS PARK PHARMACY INC
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Dates
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Enumeration Date | 05/21/2007
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Last Update Date | 05/29/2008
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Provider Practice Location Address
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Address Line | 4100 JOHNSON RD SUITE #105
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2300
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Country | US
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Telephone | 740-264-8222
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Fax | 740-264-8233
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Provider Business Mailing Address
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Address Line | 4100 JOHNSON RD SUITE #105
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City | STEUBENVILLE
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State | OH
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Zip | 43952-2300
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Country | US
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Telephone | 740-264-8222
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Fax | 740-264-8233
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | GERALD WARREN JOHN
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Credential | R.PH.
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Telephone | 740-264-8669
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 02-1701800
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License Number State | OH
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