Provider Demographics
NPI:1265512461
Name:MARCINIAK, JANICE BEVERLY (RPH)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:BEVERLY
Last Name:MARCINIAK
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 1:7142 ELGIN DR SW
Mailing Address - Street 2:
Mailing Address - City:SHERRODSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44675-9720
Mailing Address - Country:US
Mailing Address - Phone:330-401-5940
Mailing Address - Fax:
Practice Address - Street 1:551 W HIGH AVE
Practice Address - Street 2:
Practice Address - City:NEW PHILADELPHIA
Practice Address - State:OH
Practice Address - Zip Code:44663-2005
Practice Address - Country:US
Practice Address - Phone:303-394-4663
Practice Address - Fax:303-399-0073
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2021-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2--16488183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist