Provider Demographics
NPI:1497045116
Name:MEDVEC, JOHN DENNIS JR (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:DENNIS
Last Name:MEDVEC
Suffix:JR
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 1:693 MCCARTNEY RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44505-5016
Mailing Address - Country:US
Mailing Address - Phone:330-747-2426
Mailing Address - Fax:330-747-1225
Practice Address - Street 1:693 MCCARTNEY ROAD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44505
Practice Address - Country:US
Practice Address - Phone:330-747-2426
Practice Address - Fax:330-747-1225
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2011-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-20565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist