MEDICARE: ETHAN K RHODES RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03438971	OH

General Provider Information

NPI Number	:	1457954521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ETHAN K RHODES RPH

Provider Business Mailing Address
First Line	:	43 JEFFREY DR
Second Line	:
City	:	OXFORD
State	:	OH
Zip	:	45056-8900
Country	:	US
Telephone Number	:	419-681-6332
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 W SPRING ST
Second Line	:
City	:	OXFORD
State	:	OH
Zip	:	45056-1768
Country	:	US
Telephone Number	:	513-523-6378
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/19/2020
Last Update Date	:	11/19/2020

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Directions to “ ETHAN K RHODES RPH” Practice Location

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