Provider Demographics
NPI:1861624223
Name:GOODING, STEVEN JOHN (RPH)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:JOHN
Last Name:GOODING
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 1:2119 SCENIC VIEW RD SW
Mailing Address - Street 2:
Mailing Address - City:NEW PHILADELPHIA
Mailing Address - State:OH
Mailing Address - Zip Code:44663-9608
Mailing Address - Country:US
Mailing Address - Phone:330-308-8467
Mailing Address - Fax:
Practice Address - Street 1:3000 N WOOSTER AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:OH
Practice Address - Zip Code:44622-9469
Practice Address - Country:US
Practice Address - Phone:330-364-3079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03320194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist