Provider Demographics
NPI:1679173868
Name:HOUSER, HEATHER (RPH)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:HOUSER
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 1:10457 US HIGHWAY 68
Mailing Address - Street 2:
Mailing Address - City:KENTON
Mailing Address - State:OH
Mailing Address - Zip Code:43326-9206
Mailing Address - Country:US
Mailing Address - Phone:419-674-7905
Mailing Address - Fax:
Practice Address - Street 1:1241 E COLUMBUS ST
Practice Address - Street 2:
Practice Address - City:KENTON
Practice Address - State:OH
Practice Address - Zip Code:43326-1750
Practice Address - Country:US
Practice Address - Phone:419-675-1289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-28
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03118953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist