Provider Demographics
NPI:1225865074
Name:COTTRILL, BRIAN WALTER (RPH)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:WALTER
Last Name:COTTRILL
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 1:56 S BALCH ST
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44302-1538
Mailing Address - Country:US
Mailing Address - Phone:330-604-5185
Mailing Address - Fax:
Practice Address - Street 1:1323 COPLEY RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-2653
Practice Address - Country:US
Practice Address - Phone:330-867-8780
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03444823183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist