MEDICARE: TAYLOR CUSUMANO

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	03439974	OH

General Provider Information

NPI Number	:	1619570595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR CUSUMANO

Provider Business Mailing Address
First Line	:	1701 W DOROTHY LN
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1838
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 W DOROTHY LN
Second Line	:
City	:	MORAINE
State	:	OH
Zip	:	45439-1838
Country	:	US
Telephone Number	:	937-643-2481
Fax Number	:

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

Provider Enumeration Date	:	11/21/2020
Last Update Date	:	03/11/2026

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Directions to “ TAYLOR CUSUMANO ” Practice Location

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