Provider Demographics
NPI:1417447046
Name:SOLOMON, CYNTHIA SHEPPARD
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SHEPPARD
Last Name:SOLOMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CYNTHIA SHEPPARD
Other - Middle Name:
Other - Last Name:SOLOMON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BSPHARM RPH CTTS
Mailing Address - Street 1:1075 W RAHN RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2048
Mailing Address - Country:US
Mailing Address - Phone:937-439-2327
Mailing Address - Fax:937-439-2877
Practice Address - Street 1:1075 W RAHN RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45429-2048
Practice Address - Country:US
Practice Address - Phone:937-439-2327
Practice Address - Fax:937-439-2877
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03213283183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist