Provider Demographics
NPI:1134233216
Name:KASUN, HERBERT LEWIS (RPH)
Entity type:Individual
Prefix:MR
First Name:HERBERT
Middle Name:LEWIS
Last Name:KASUN
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 1:906 LAKEVIEW DR.
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:OH
Mailing Address - Zip Code:45715
Mailing Address - Country:US
Mailing Address - Phone:740-984-2414
Mailing Address - Fax:740-984-2305
Practice Address - Street 1:501 DIETZ LANE
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:OH
Practice Address - Zip Code:45715
Practice Address - Country:US
Practice Address - Phone:740-984-2305
Practice Address - Fax:740-984-2522
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-0998183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist