Provider Demographics
NPI:1831498187
Name:MASON, KAREN ANNETTE (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNETTE
Last Name:MASON
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 1:1047 KENMORE BLVD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44314-2154
Mailing Address - Country:US
Mailing Address - Phone:330-753-3095
Mailing Address - Fax:330-753-7243
Practice Address - Street 1:1047 KENMORE BLVD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44314-2154
Practice Address - Country:US
Practice Address - Phone:330-753-3095
Practice Address - Fax:330-753-7243
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2011-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03317490183500000X
MO040316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist