Provider Demographics
NPI:1134903438
Name:YOSICK, PAUL (RPH)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:YOSICK
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 1:3662 LAKE MEAD DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8562
Mailing Address - Country:US
Mailing Address - Phone:614-288-8613
Mailing Address - Fax:
Practice Address - Street 1:2110 STRINGTOWN RD
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-2931
Practice Address - Country:US
Practice Address - Phone:614-277-1325
Practice Address - Fax:614-277-1395
Is Sole Proprietor?:No
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03443570183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist