Provider Demographics
NPI:1508513946
Name:ANTHONY, MARCUS FARREL (RPH)
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:FARREL
Last Name:ANTHONY
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 1:825 BLUFFVIEW DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-1727
Mailing Address - Country:US
Mailing Address - Phone:614-266-2511
Mailing Address - Fax:614-732-5840
Practice Address - Street 1:2343 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-1611
Practice Address - Country:US
Practice Address - Phone:614-388-8088
Practice Address - Fax:614-732-5840
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-06
Last Update Date:2022-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH031244871835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist