Provider Demographics
NPI:1548590789
Name:HOMAN, ALVIN JOHN (RPH)
Entity Type:Individual
Prefix:
First Name:ALVIN
Middle Name:JOHN
Last Name:HOMAN
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 1:172 S GARFIELD ST
Mailing Address - Street 2:
Mailing Address - City:MINSTER
Mailing Address - State:OH
Mailing Address - Zip Code:45865-1318
Mailing Address - Country:US
Mailing Address - Phone:419-628-3198
Mailing Address - Fax:
Practice Address - Street 1:8264 W STATE ROUTE 41
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:OH
Practice Address - Zip Code:45318-1248
Practice Address - Country:US
Practice Address - Phone:937-473-3333
Practice Address - Fax:937-473-3000
Is Sole Proprietor?:No
Enumeration Date:2010-01-11
Last Update Date:2010-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03211249183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist