Provider Demographics
NPI:1881118818
Name:TOTH, ROBERT JAKOB (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAKOB
Last Name:TOTH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 S HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-4481
Mailing Address - Country:US
Mailing Address - Phone:216-533-9540
Mailing Address - Fax:
Practice Address - Street 1:12395 MCCRACKEN RD STE A
Practice Address - Street 2:
Practice Address - City:GARFIELD HTS
Practice Address - State:OH
Practice Address - Zip Code:44125-2946
Practice Address - Country:US
Practice Address - Phone:216-587-6727
Practice Address - Fax:216-587-6727
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-01
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OH03233212183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0929259Medicaid