Provider Demographics
NPI:1689655573
Name:STRAUB, MARIAN (RPH)
Entity Type:Individual
Prefix:
First Name:MARIAN
Middle Name:
Last Name:STRAUB
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 1:114 OTTERBEIN DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:44904-9783
Mailing Address - Country:US
Mailing Address - Phone:419-884-0837
Mailing Address - Fax:
Practice Address - Street 1:1500 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2632
Practice Address - Country:US
Practice Address - Phone:419-756-7023
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3217965183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist