Provider Demographics
NPI:1467734905
Name:KITCHEN, ANTHONY ROSS (RPH)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:ROSS
Last Name:KITCHEN
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 1:36725 GLENDENNING ST
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:OH
Mailing Address - Zip Code:44011-3459
Mailing Address - Country:US
Mailing Address - Phone:440-552-4930
Mailing Address - Fax:
Practice Address - Street 1:36725 GLENDENNING ST
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:OH
Practice Address - Zip Code:44011-3459
Practice Address - Country:US
Practice Address - Phone:440-552-4930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-11
Last Update Date:2011-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03122669183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist