Provider Demographics
NPI:1528335015
Name:DISHOP, DARIN ERIC (RPH)
Entity type:Individual
Prefix:MR
First Name:DARIN
Middle Name:ERIC
Last Name:DISHOP
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 1:1425 NORTH 21 ST. STREET
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055
Mailing Address - Country:US
Mailing Address - Phone:740-366-7119
Mailing Address - Fax:740-366-0933
Practice Address - Street 1:1425 N 21ST ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3069
Practice Address - Country:US
Practice Address - Phone:740-366-7119
Practice Address - Fax:740-366-0933
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-20154183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist