Provider Demographics
NPI:1992086557
Name:SIGRIST, MARY M (RPH)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:M
Last Name:SIGRIST
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1990 HARMON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43223-3829
Mailing Address - Country:US
Mailing Address - Phone:614-445-5960
Mailing Address - Fax:
Practice Address - Street 1:1990 HARMON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43223-3829
Practice Address - Country:US
Practice Address - Phone:614-441-0563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-08
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-30507183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist