MEDICARE: MARLENA PUHALJ PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03444813	OH

General Provider Information

NPI Number	:	1063236685
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARLENA PUHALJ PHARMD

Provider Business Mailing Address
First Line	:	13215 SHAKER SQ
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2314
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	13215 SHAKER SQ
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2314
Country	:	US
Telephone Number	:	216-991-3904
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/11/2024
Last Update Date	:	11/11/2024

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Directions to “ MARLENA PUHALJ PHARMD” Practice Location

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