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NPI Code Detail

MEDICARE: ALLEN BRUCE WEAVER RPH

MEDICARE: ALLEN BRUCE WEAVER 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
1183500000XPharmacist03-1-12438OH

General Provider Information

NPI Number : 1891819892
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALLEN BRUCE WEAVER RPH
Provider Business Mailing Address
First Line : 15753 BALMORAL CT
Second Line :
City : STRONGSVILLE
State : OH
Zip : 44136-2594
Country : US
Telephone Number : 440-238-1568
Fax Number :
Provider Business Practice Location Address
First Line : 3402 CLARK AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44109-1136
Country : US
Telephone Number : 216-961-9414
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2007
Last Update Date : 07/08/2007

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