Provider Demographics
NPI:1598989675
Name:NOTARANTONIO, JOE (RPH)
Entity Type:Individual
Prefix:MR
First Name:JOE
Middle Name:
Last Name:NOTARANTONIO
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 1:105 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:WEIRTON
Mailing Address - State:WV
Mailing Address - Zip Code:26062-3740
Mailing Address - Country:US
Mailing Address - Phone:304-723-5015
Mailing Address - Fax:
Practice Address - Street 1:503 CADIZ RD
Practice Address - Street 2:
Practice Address - City:WINTERSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43953-4126
Practice Address - Country:US
Practice Address - Phone:740-264-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-24447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist