Healthcare Provider Details

I. General information

NPI: 1265358295
Provider Name (Legal Business Name): MOLLIE MARILYN VERGARA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 SAND RUN RD
AKRON OH
44313-6288
US

IV. Provider business mailing address

2295 CONGO ST
AKRON OH
44305-3860
US

V. Phone/Fax

Practice location:
  • Phone: 330-864-2138
  • Fax:
Mailing address:
  • Phone: 330-304-8598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446772
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: