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General NPI Number Information
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NPI Number | 1669600268
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Entity Type | Individual
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Provider Name | ROGER CHARLES EDGINGTON R. PH.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/24/2009
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Provider Practice Location Address
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Address Line | 3540 BURBANK RD
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City | WOOSTER
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State | OH
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Zip | 44691-8539
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Country | US
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Telephone | 330-345-6905
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Fax | 330-345-0925
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Provider Business Mailing Address
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Address Line | 2741 TUCKAHOE RD
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City | WOOSTER
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State | OH
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Zip | 44691-3855
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Country | US
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Telephone | 330-264-2635
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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 | 03109571
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License Number State | OH
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