Provider Demographics
NPI:1619421005
Name:MENNING, TEARINA (RPH)
Entity Type:Individual
Prefix:
First Name:TEARINA
Middle Name:
Last Name:MENNING
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 1:1787 CUNNINGHAM RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-9406
Mailing Address - Country:US
Mailing Address - Phone:330-831-0746
Mailing Address - Fax:
Practice Address - Street 1:2012 S UNION AVE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-4951
Practice Address - Country:US
Practice Address - Phone:330-829-3782
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-15
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03136192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist