Provider Demographics
NPI:1598054280
Name:MATRONIA, BARBARA JEAN (RPH)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:JEAN
Last Name:MATRONIA
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 1:7257 FULTON DR NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-3816
Mailing Address - Country:US
Mailing Address - Phone:330-833-9797
Mailing Address - Fax:330-834-2875
Practice Address - Street 1:7257 FULTON DR NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-3816
Practice Address - Country:US
Practice Address - Phone:330-833-9797
Practice Address - Fax:330-834-2875
Is Sole Proprietor?:No
Enumeration Date:2011-04-04
Last Update Date:2011-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03219395183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist