MEDICARE: MR. ALAN ROBERT KAZAN PHARMACIST

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	1835P1200X	Pharmacotherapy Pharmacist	03-1-10973	OH

General Provider Information

NPI Number	:	1134122807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ALAN ROBERT KAZAN PHARMACIST

Provider Business Mailing Address
First Line	:	8730 ARBORHURST LN
Second Line	:
City	:	KIRTLAND
State	:	OH
Zip	:	44094-9323
Country	:	US
Telephone Number	:	440-256-2695
Fax Number	:	216-531-0877

Provider Business Practice Location Address
First Line	:	1464 E 105TH ST
Second Line	:	STE 201
City	:	CLEVELAND
State	:	OH
Zip	:	44106-1100
Country	:	US
Telephone Number	:	216-721-5776
Fax Number	:	216-721-5888

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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