Provider Demographics
NPI:1831498187
Name:MASON, KAREN ANNETTE (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:ANNETTE
Last Name:MASON
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 1:2000 VILLAGE PKWY
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-3038
Mailing Address - Country:US
Mailing Address - Phone:330-608-9476
Mailing Address - Fax:
Practice Address - Street 1:2000 VILLAGE PKWY
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-3038
Practice Address - Country:US
Practice Address - Phone:
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-24
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO040316183500000X
OH03317490183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist