Provider Demographics
NPI:1356862403
Name:GENTILE, JOHN THOMAS (PHARMACY)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:THOMAS
Last Name:GENTILE
Suffix:
Gender:M
Credentials:PHARMACY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5911 WECKERLY ROAD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571
Mailing Address - Country:US
Mailing Address - Phone:419-877-5233
Mailing Address - Fax:419-877-5275
Practice Address - Street 1:5911 WECKERLY RD
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9648
Practice Address - Country:US
Practice Address - Phone:419-877-5233
Practice Address - Fax:419-877-5275
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0226941503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy