Provider Demographics
NPI:1003533571
Name:WARNER, CAMERON MARK (PHARMD)
Entity Type:Individual
Prefix:
First Name:CAMERON
Middle Name:MARK
Last Name:WARNER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3292 CAIN ST NW
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-4434
Mailing Address - Country:US
Mailing Address - Phone:330-365-6005
Mailing Address - Fax:
Practice Address - Street 1:238 2ND ST NW
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-3747
Practice Address - Country:US
Practice Address - Phone:330-339-6040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-10-25
Last Update Date:2022-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03442065183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist