Provider Demographics
NPI:1780969212
Name:VOSS, TAYLOR C (RPH)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:C
Last Name:VOSS
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 1:143 LAKE ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1128
Mailing Address - Country:US
Mailing Address - Phone:740-335-3180
Mailing Address - Fax:740-335-3650
Practice Address - Street 1:1240 COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:WASHINGTON COURT HOUSE
Practice Address - State:OH
Practice Address - Zip Code:43160-1655
Practice Address - Country:US
Practice Address - Phone:740-335-3180
Practice Address - Fax:740-335-3650
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03230552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist