Provider Demographics
NPI:1679687909
Name:WARREN, ERNEST PAUL (RPH)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:PAUL
Last Name:WARREN
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 1:23435 SR 339
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45715
Mailing Address - Country:US
Mailing Address - Phone:740-984-4783
Mailing Address - Fax:740-984-2522
Practice Address - Street 1:501 DIETZ LANE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:OH
Practice Address - Zip Code:45715
Practice Address - Country:US
Practice Address - Phone:740-984-2305
Practice Address - Fax:740-984-2522
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-11830183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist