Provider Demographics
NPI:1205588464
Name:DAPORE, CYNTHIA M (RPH)
Entity type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:M
Last Name:DAPORE
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 1:100 FORT JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1383
Mailing Address - Country:US
Mailing Address - Phone:937-547-1642
Mailing Address - Fax:937-547-2292
Practice Address - Street 1:100 FORT JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1383
Practice Address - Country:US
Practice Address - Phone:937-547-1642
Practice Address - Fax:937-547-2292
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-19
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03217819183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist