Provider Demographics
NPI:1134591886
Name:PARISH, ELLIS HOWARD (RPH)
Entity type:Individual
Prefix:
First Name:ELLIS
Middle Name:HOWARD
Last Name:PARISH
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 1:3531 HARRIS AVE NW
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44708-1020
Mailing Address - Country:US
Mailing Address - Phone:330-477-3957
Mailing Address - Fax:
Practice Address - Street 1:3531 HARRIS AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-1020
Practice Address - Country:US
Practice Address - Phone:330-477-3957
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-12902183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH03-3-12902OtherREGISTERED PHARMACIST