Provider Demographics
NPI:1275808032
Name:PRICE, CHARLOTTE ANNE (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:ANNE
Last Name:PRICE
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 1:5013 LAKE BREEZE LNDG
Mailing Address - Street 2:
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-6057
Mailing Address - Country:US
Mailing Address - Phone:321-356-8574
Mailing Address - Fax:
Practice Address - Street 1:320 S WATER ST
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3528
Practice Address - Country:US
Practice Address - Phone:330-677-5650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-13
Last Update Date:2012-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03326828-3183500000X
FLPS36091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist