Healthcare Provider Details

I. General information

NPI: 1174805832
Provider Name (Legal Business Name): MRS. CHANICE D NEWCOMER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2011
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 E MARKET ST
AKRON OH
44305-2421
US

IV. Provider business mailing address

5500 HILLSIDE RD
INDEPENDENCE OH
44131-5314
US

V. Phone/Fax

Practice location:
  • Phone: 330-315-3719
  • Fax: 330-315-3784
Mailing address:
  • Phone: 702-655-7258
  • Fax: 702-655-7295

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03134177
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number17439
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: