Provider Demographics
NPI:1972840502
Name:CATHER, CHARLES WAYNE (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:WAYNE
Last Name:CATHER
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4016 MASSILLON RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7818
Mailing Address - Country:US
Mailing Address - Phone:330-899-0406
Mailing Address - Fax:330-899-0652
Practice Address - Street 1:4016 MASSILLON RD
Practice Address - Street 2:SUITE B
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7818
Practice Address - Country:US
Practice Address - Phone:330-899-0406
Practice Address - Fax:330-899-0652
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2013-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03212553183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist