Provider Demographics
NPI:1396821500
Name:CLINE, CURTIS RICHARD (RPH)
Entity Type:Individual
Prefix:MR
First Name:CURTIS
Middle Name:RICHARD
Last Name:CLINE
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 1:1203 DEER PATH ST
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8750
Mailing Address - Country:US
Mailing Address - Phone:614-875-8463
Mailing Address - Fax:
Practice Address - Street 1:1020 DENNISON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201
Practice Address - Country:US
Practice Address - Phone:614-291-7707
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-08461183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2201423Medicaid