Provider Demographics
NPI:1245217488
Name:DEHOFF, ANTHONY BLAIR (RPH)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:BLAIR
Last Name:DEHOFF
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1495 MORSE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43229-6478
Mailing Address - Country:US
Mailing Address - Phone:614-267-4931
Mailing Address - Fax:614-267-0569
Practice Address - Street 1:1495 MORSE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-6478
Practice Address - Country:US
Practice Address - Phone:614-267-4931
Practice Address - Fax:614-267-0569
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-23464183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist