Provider Demographics
NPI:1942800156
Name:ANTHONY, CATHY (RPH)
Entity Type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:ANTHONY
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 1:614 RED ROCK DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-2284
Mailing Address - Country:US
Mailing Address - Phone:330-618-2107
Mailing Address - Fax:
Practice Address - Street 1:2753 W MARKET ST
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4235
Practice Address - Country:US
Practice Address - Phone:330-869-0426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03113576183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist