Healthcare Provider Details

I. General information

NPI: 1952631616
Provider Name (Legal Business Name): COMMUNITY DRUG BOARD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 12/23/2025
Certification Date: 12/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

719 E MARKET ST
AKRON OH
44305-2421
US

IV. Provider business mailing address

725 E MARKET ST
AKRON OH
44305-2421
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-2760
  • Fax:
Mailing address:
  • Phone: 330-315-2666
  • Fax: 330-315-5230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number34.002564
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number34.002564
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number34.002564
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code261QM2800X
TaxonomyMethadone Clinic
License Number34.002564
License Number StateOH
# 6
Primary TaxonomyY
Taxonomy Code291U00000X
TaxonomyClinical Medical Laboratory
License Number36D0340567
License Number StateOH

VIII. Authorized Official

Name: MICHELLE A MARSHALL
Title or Position: CFO
Credential:
Phone: 330-315-3708