Provider Demographics
NPI:1205422458
Name:RITO, SHAWN
Entity type:Individual
Prefix:
First Name:SHAWN
Middle Name:
Last Name:RITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3926 MAIDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:GAHANNA
Mailing Address - State:OH
Mailing Address - Zip Code:43230-4512
Mailing Address - Country:US
Mailing Address - Phone:614-774-5636
Mailing Address - Fax:
Practice Address - Street 1:1202 COUNTY LINE RD
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43081-6015
Practice Address - Country:US
Practice Address - Phone:614-891-8300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03334339183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist