MEDICARE: JOSEPH MAREK SR. RPH CGP

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	1835G0303X	Geriatric Pharmacist	03-3-18455	OH

General Provider Information

NPI Number	:	1194849760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH MAREK SR. RPH CGP

Provider Business Mailing Address
First Line	:	1103 SHELTON CIR
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-4259
Country	:	US
Telephone Number	:	440-263-1752
Fax Number	:

Provider Business Practice Location Address
First Line	:	1103 SHELTON CIR
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-4259
Country	:	US
Telephone Number	:	440-263-1752
Fax Number	:

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

Provider Enumeration Date	:	03/19/2007
Last Update Date	:	07/08/2007

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