Provider Demographics
NPI:1457375065
Name:ANZEVINO, ALYNN M (RPH)
Entity Type:Individual
Prefix:
First Name:ALYNN
Middle Name:M
Last Name:ANZEVINO
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 1:8920 CANYON FALLS BLVD
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1973
Mailing Address - Country:US
Mailing Address - Phone:330-486-2850
Mailing Address - Fax:330-486-2855
Practice Address - Street 1:8920 CANYON FALLS BLVD
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1973
Practice Address - Country:US
Practice Address - Phone:330-486-2850
Practice Address - Fax:330-486-2855
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-25514183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist