Provider Demographics
NPI:1629059118
Name:MOHR, CHARLES R (R PH)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:R
Last Name:MOHR
Suffix:
Gender:M
Credentials:R PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6526 BURDETT RD
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-9719
Mailing Address - Country:US
Mailing Address - Phone:330-239-2430
Mailing Address - Fax:330-239-2430
Practice Address - Street 1:1323 COPLEY RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2653
Practice Address - Country:US
Practice Address - Phone:330-867-8780
Practice Address - Fax:330-867-8973
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-25950183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist