Provider Demographics
NPI:1043560378
Name:SOBOWALE, FELICIA T (RPH)
Entity Type:Individual
Prefix:MRS
First Name:FELICIA
Middle Name:T
Last Name:SOBOWALE
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 WOOSTER RD N
Mailing Address - Street 2:
Mailing Address - City:BARBERTON
Mailing Address - State:OH
Mailing Address - Zip Code:44203-2560
Mailing Address - Country:US
Mailing Address - Phone:330-745-9922
Mailing Address - Fax:330-745-4035
Practice Address - Street 1:241 WOOSTER RD N
Practice Address - Street 2:
Practice Address - City:BARBERTON
Practice Address - State:OH
Practice Address - Zip Code:44203-2560
Practice Address - Country:US
Practice Address - Phone:330-745-9922
Practice Address - Fax:330-745-4035
Is Sole Proprietor?:No
Enumeration Date:2012-09-13
Last Update Date:2012-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist