Provider Demographics
NPI:1467988659
Name:MAY, DENISE ANN (RPH)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:ANN
Last Name:MAY
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 1:123 W HIGH ST
Mailing Address - Street 2:
Mailing Address - City:FOSTORIA
Mailing Address - State:OH
Mailing Address - Zip Code:44830-2133
Mailing Address - Country:US
Mailing Address - Phone:419-435-4190
Mailing Address - Fax:419-435-4355
Practice Address - Street 1:123 W HIGH ST
Practice Address - Street 2:
Practice Address - City:FOSTORIA
Practice Address - State:OH
Practice Address - Zip Code:44830-2133
Practice Address - Country:US
Practice Address - Phone:419-435-4190
Practice Address - Fax:419-435-4355
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-07
Last Update Date:2017-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03114777183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist