MEDICARE: LATOYA ROSS 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	03-1-24826	OH

General Provider Information

NPI Number	:	1821199837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LATOYA ROSS RPH

Provider Business Mailing Address
First Line	:	3798 FAIROAKS RD
Second Line	:
City	:	SOUTH EUCLID
State	:	OH
Zip	:	44121-1923
Country	:	US
Telephone Number	:	216-445-2348
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 EAST 90TH STREET
Second Line	:	SUITE R16
City	:	CLEVELAND
State	:	OH
Zip	:	44106
Country	:	US
Telephone Number	:	216-445-2348
Fax Number	:

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

Provider Enumeration Date	:	09/25/2006
Last Update Date	:	07/08/2007

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