Provider Demographics
NPI:1992794077
Name:ST. ANGELO, GENEVIEVE ANN (PHARMD, RPH)
Entity type:Individual
Prefix:DR
First Name:GENEVIEVE
Middle Name:ANN
Last Name:ST. ANGELO
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8543 HALLEY DR
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-8952
Mailing Address - Country:US
Mailing Address - Phone:614-339-4437
Mailing Address - Fax:
Practice Address - Street 1:2940 GROVEPORT RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-3255
Practice Address - Country:US
Practice Address - Phone:614-491-3446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2011-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-3-26741183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist