Provider Demographics
NPI:1942508817
Name:KATZ, AMY J (RPH)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:J
Last Name:KATZ
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 1:15596 W HIGH ST
Mailing Address - Street 2:PO BOX 247
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9292
Mailing Address - Country:US
Mailing Address - Phone:440-632-5201
Mailing Address - Fax:440-632-1100
Practice Address - Street 1:15596 W HIGH ST
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9292
Practice Address - Country:US
Practice Address - Phone:440-632-5201
Practice Address - Fax:440-632-1100
Is Sole Proprietor?:No
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03215112183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist