Provider Demographics
NPI:1457431645
Name:VERNON, ARTHUR EUGENE (RPH)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:EUGENE
Last Name:VERNON
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 1:1185 N CROWN HILL RD
Mailing Address - Street 2:
Mailing Address - City:ORRVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44667-2318
Mailing Address - Country:US
Mailing Address - Phone:330-682-5746
Mailing Address - Fax:
Practice Address - Street 1:119 NORTH MARKET ST
Practice Address - Street 2:
Practice Address - City:SHREVE
Practice Address - State:OH
Practice Address - Zip Code:44676
Practice Address - Country:US
Practice Address - Phone:330-567-2823
Practice Address - Fax:330-567-2660
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-08814183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist