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NPI Code Detail

MEDICARE: NOREEN A WILSON RPH

MEDICARE: NOREEN A WILSON 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
1183500000XPharmacist03216574OH

General Provider Information

NPI Number : 1700884368
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOREEN A WILSON RPH
Provider Business Mailing Address
First Line : 1211 OXFORD RD
Second Line :
City : CLEVELAND HTS
State : OH
Zip : 44121-1829
Country : US
Telephone Number : 216-381-6787
Fax Number : 216-761-2859
Provider Business Practice Location Address
First Line : 13951 TERRACE RD
Second Line :
City : EAST CLEVELAND
State : OH
Zip : 44112-4308
Country : US
Telephone Number : 216-761-6999
Fax Number : 216-761-2859
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 07/08/2007

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