MEDICARE: DISCOUNT DRUG MART, INC.

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	332B00000X	Durable Medical Equipment & Medical Supplies	010021900	OH
2	3336C0003X	Community/Retail Pharmacy	010021900	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447392477
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DISCOUNT DRUG MART, INC.

Provider Business Mailing Address
First Line	:	211 COMMERCE DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-1331
Country	:	US
Telephone Number	:	800-434-9440
Fax Number	:	330-725-5780

Provider Business Practice Location Address
First Line	:	211 COMMERCE DR
Second Line	:
City	:	MEDINA
State	:	OH
Zip	:	44256-1331
Country	:	US
Telephone Number	:	800-434-9440
Fax Number	:	330-725-5780

Authorized Official
Title or Position	:	CHIEF FINANCIAL OFFICER
Name	:	MICHAEL R EBY
Credential	:
Telephone Number	:	330-725-2340

Provider Enumeration Date	:	02/13/2007
Last Update Date	:	09/14/2016

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Directions to “DISCOUNT DRUG MART, INC. ” Practice Location

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