MEDICARE: MR. ERROL DURONSLET 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
1	183500000X	Pharmacist	03-3-09692	OH

General Provider Information

NPI Number	:	1750379343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ERROL DURONSLET RPH

Provider Business Mailing Address
First Line	:	4481 SPRINGVALE DR
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44128-5010
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2816 E 116TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44120-2111
Country	:	US
Telephone Number	:	216-957-4050
Fax Number	:

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

Provider Enumeration Date	:	10/09/2005
Last Update Date	:	07/08/2007

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