Provider Demographics
NPI:1508520651
Name:GAMBLE, AURELIA CARMEN (RPH)
Entity Type:Individual
Prefix:
First Name:AURELIA
Middle Name:CARMEN
Last Name:GAMBLE
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 1:5321 WARRENSVILLE CENTER RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44137-1908
Mailing Address - Country:US
Mailing Address - Phone:216-332-9592
Mailing Address - Fax:
Practice Address - Street 1:5321 WARRENSVILLE CENTER RD
Practice Address - Street 2:
Practice Address - City:MAPLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44137-1908
Practice Address - Country:US
Practice Address - Phone:216-332-9592
Practice Address - Fax:216-332-9615
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03224900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist