Provider Demographics
NPI:1194988592
Name:VRONTOS, EMILY BELLEBAUM (PHARMD)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:BELLEBAUM
Last Name:VRONTOS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2231 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43201-1101
Mailing Address - Country:US
Mailing Address - Phone:614-293-2700
Mailing Address - Fax:
Practice Address - Street 1:2231 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43201-1101
Practice Address - Country:US
Practice Address - Phone:614-293-2700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-07
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC012097183500000X
OH03129622-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist