Provider Demographics
NPI:1508466988
Name:CLOSSON, ASHLEY (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:CLOSSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13225 CLARK ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:OH
Mailing Address - Zip Code:43569-9710
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 S MAIN ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:OH
Practice Address - Zip Code:43506-2442
Practice Address - Country:US
Practice Address - Phone:419-636-9153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-27
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03338051183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist