Provider Demographics
NPI:1316923873
Name:SPENCER, CYNTHIA J (RPH, BCOP)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:J
Last Name:SPENCER
Suffix:
Gender:F
Credentials:RPH, BCOP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8100 LONG FOREST DR
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1848
Mailing Address - Country:US
Mailing Address - Phone:440-655-0521
Mailing Address - Fax:
Practice Address - Street 1:29325 HEALTH CAMPUS DR STE 1
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-8201
Practice Address - Country:US
Practice Address - Phone:440-617-4689
Practice Address - Fax:440-617-4643
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-16
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03318164183500000X, 1835X0200X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist
No1835X0200XPharmacy Service ProvidersPharmacistOncology