Provider Demographics
NPI:1679796361
Name:RIBICH, WILLIAM N (RPH)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:N
Last Name:RIBICH
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 1:8053 BITTERSWEET RD
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-1000
Mailing Address - Country:US
Mailing Address - Phone:419-885-8137
Mailing Address - Fax:
Practice Address - Street 1:4869 N SUMMIT ST
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43611-2854
Practice Address - Country:US
Practice Address - Phone:419-726-8449
Practice Address - Fax:419-726-5895
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-2-12621183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist