Provider Demographics
NPI:1700888096
Name:SPEERHAS, REX A (RPH, CDE, BCNSP)
Entity Type:Individual
Prefix:MR
First Name:REX
Middle Name:A
Last Name:SPEERHAS
Suffix:
Gender:M
Credentials:RPH, CDE, BCNSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2100 BERKELEY DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-3220
Mailing Address - Country:US
Mailing Address - Phone:216-444-6315
Mailing Address - Fax:216-444-4380
Practice Address - Street 1:DEPARTMENT OF PHARMACY, QQB5
Practice Address - Street 2:9500 EUCLID AVENUE
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195
Practice Address - Country:US
Practice Address - Phone:216-444-6315
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-109641835N1003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835N1003XPharmacy Service ProvidersPharmacistNutrition Support