Provider Demographics
NPI:1962756023
Name:SAMUEL, GEETA VIRGINIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:GEETA
Middle Name:VIRGINIA
Last Name:SAMUEL
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 1:19 LONDON RD
Mailing Address - Street 2:
Mailing Address - City:DELAWARE
Mailing Address - State:OH
Mailing Address - Zip Code:43015-2613
Mailing Address - Country:US
Mailing Address - Phone:740-368-9380
Mailing Address - Fax:740-368-8520
Practice Address - Street 1:19 LONDON RD
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-2613
Practice Address - Country:US
Practice Address - Phone:740-368-9380
Practice Address - Fax:740-368-8520
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-28
Last Update Date:2012-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03223335183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist