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NPI Code Detail

MEDICARE: DANA L TALLEY RPH.

MEDICARE: DANA L TALLEY RPH.
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
1183500000XPharmacist03-1-17458OH

General Provider Information

NPI Number : 1447264478
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANA L TALLEY RPH.
Provider Business Mailing Address
First Line : 1510 MIDDLETON RD
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44121-1706
Country : US
Telephone Number : 216-291-1381
Fax Number :
Provider Business Practice Location Address
First Line : 10 SEVERANCE CIR
Second Line : PHARMACY
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-1533
Country : US
Telephone Number : 216-297-2601
Fax Number : 216-297-2610
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 07/08/2007

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Directions to “ DANA L TALLEY RPH.” Practice Location

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