Provider Demographics
NPI:1942671649
Name:SOLOMON, ANITA (RPH)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:SOLOMON
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 1:3210 HADLEIGH PL
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-9465
Mailing Address - Country:US
Mailing Address - Phone:812-949-8256
Mailing Address - Fax:
Practice Address - Street 1:3210 HADLEIGH PL
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-9465
Practice Address - Country:US
Practice Address - Phone:812-949-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26016976A183500000X
KY011025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist