Provider Demographics
NPI:1558671024
Name:MCCAW, ERIC J (BS)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:J
Last Name:MCCAW
Suffix:
Gender:M
Credentials:BS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:339 E MAPLE ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44720-2593
Mailing Address - Country:US
Mailing Address - Phone:330-498-8130
Mailing Address - Fax:330-498-8154
Practice Address - Street 1:339 E MAPLE ST
Practice Address - Street 2:SUITE 100
Practice Address - City:NORTH CANTON
Practice Address - State:OH
Practice Address - Zip Code:44720-2593
Practice Address - Country:US
Practice Address - Phone:330-498-8130
Practice Address - Fax:330-498-8154
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH03-2-23158183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03-2-23158OtherOHIO STATE BOARD OF PHARMACY