Provider Demographics
NPI:1861098022
Name:GALUZNY, RAYMOND EDWARD (RPH)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:EDWARD
Last Name:GALUZNY
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 1:1448 BROOKPARK DR
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44906-3504
Mailing Address - Country:US
Mailing Address - Phone:419-571-9433
Mailing Address - Fax:
Practice Address - Street 1:1411 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-2629
Practice Address - Country:US
Practice Address - Phone:419-756-1321
Practice Address - Fax:419-756-6632
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03310472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty