Provider Demographics
NPI:1912292541
Name:GOSHE, JILL M (RPH)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:GOSHE
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 1:762 ARLINGTON RDG
Mailing Address - Street 2:T-2346
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5269
Mailing Address - Country:US
Mailing Address - Phone:330-645-8253
Mailing Address - Fax:330-645-8253
Practice Address - Street 1:762 ARLINGTON RDG
Practice Address - Street 2:T-2346
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5269
Practice Address - Country:US
Practice Address - Phone:330-645-8253
Practice Address - Fax:330-645-8253
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-11
Last Update Date:2011-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03124839183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist