Provider Demographics
NPI:1417482563
Name:PFEIFFER, BETH (RPH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:
Last Name:PFEIFFER
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 1:1060 ASHLAND RD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2157
Mailing Address - Country:US
Mailing Address - Phone:419-589-3693
Mailing Address - Fax:419-589-3693
Practice Address - Street 1:1060 ASHLAND RD
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-2157
Practice Address - Country:US
Practice Address - Phone:419-589-3693
Practice Address - Fax:419-589-3693
Is Sole Proprietor?:No
Enumeration Date:2017-04-26
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120815183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist