Provider Demographics
NPI:1316540107
Name:ROSSI, CHRISTOPHER MARIO (RPH)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:MARIO
Last Name:ROSSI
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 1:7105 GOLDLEAF DR
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:OH
Mailing Address - Zip Code:43528-7903
Mailing Address - Country:US
Mailing Address - Phone:567-288-4972
Mailing Address - Fax:
Practice Address - Street 1:3316 NAVARRE AVE STE E
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3301
Practice Address - Country:US
Practice Address - Phone:419-691-3814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03335005183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist