Provider Demographics
NPI:1528359726
Name:HARRISON, DAVID TODD (RPH)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:TODD
Last Name:HARRISON
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 1:521 SNAZZY CIR SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-7083
Mailing Address - Country:US
Mailing Address - Phone:330-308-8821
Mailing Address - Fax:
Practice Address - Street 1:735 N WATER ST
Practice Address - Street 2:
Practice Address - City:UHRICHSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44683-1455
Practice Address - Country:US
Practice Address - Phone:740-922-7587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2011-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03120988183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist