Provider Demographics
NPI:1770878548
Name:MINOR, PAUL DONALDSON (PHARM D)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:DONALDSON
Last Name:MINOR
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36195 EUCLID AVE
Mailing Address - Street 2:PHARMACY
Mailing Address - City:WILLOUGHBY
Mailing Address - State:OH
Mailing Address - Zip Code:44094-4410
Mailing Address - Country:US
Mailing Address - Phone:440-975-1983
Mailing Address - Fax:440-975-1983
Practice Address - Street 1:36195 EUCLID AVE
Practice Address - Street 2:PHARMACY
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-4410
Practice Address - Country:US
Practice Address - Phone:440-975-1983
Practice Address - Fax:440-975-1983
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03328920183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist