Provider Demographics
NPI:1215142237
Name:LABS, FREDERICK JOHN (RPH)
Entity type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:JOHN
Last Name:LABS
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 1:1718 STEINHILBER DR
Mailing Address - Street 2:
Mailing Address - City:PIQUA
Mailing Address - State:OH
Mailing Address - Zip Code:45356-9106
Mailing Address - Country:US
Mailing Address - Phone:937-778-1539
Mailing Address - Fax:
Practice Address - Street 1:1510 COVINGTON AVE
Practice Address - Street 2:
Practice Address - City:PIQUA
Practice Address - State:OH
Practice Address - Zip Code:45356-2801
Practice Address - Country:US
Practice Address - Phone:937-615-7020
Practice Address - Fax:937-615-7055
Is Sole Proprietor?:No
Enumeration Date:2007-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-15546183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist