Provider Demographics
NPI:1205817772
Name:CORSI, ANNA MARIA (RPH)
Entity Type:Individual
Prefix:MISS
First Name:ANNA
Middle Name:MARIA
Last Name:CORSI
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 1:4465 BURBANK RD
Mailing Address - Street 2:APT 6C
Mailing Address - City:WOOSTER
Mailing Address - State:OH
Mailing Address - Zip Code:44691-7245
Mailing Address - Country:US
Mailing Address - Phone:330-465-5431
Mailing Address - Fax:
Practice Address - Street 1:3540 BURBANK RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-8539
Practice Address - Country:US
Practice Address - Phone:330-345-5908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-19800183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist