Healthcare Provider Details

I. General information

NPI: 1124116603
Provider Name (Legal Business Name): JON EDWARD FOLSTAD PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 EAST BLVD LOUIS STOKES CLEVELAND VAMC (119W)
CLEVELAND OH
44106
US

IV. Provider business mailing address

35900 BAINBRIDGE RD
SOLON OH
44139-3117
US

V. Phone/Fax

Practice location:
  • Phone: 216-791-3800
  • Fax: 216-231-3291
Mailing address:
  • Phone: 216-791-3800
  • Fax: 216-231-3291

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03316842
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03316842
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: