Healthcare Provider Details

I. General information

NPI: 1386507994
Provider Name (Legal Business Name): TAWNA LEIGH MANGOSH PHARMD, PHD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2025
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10900 EUCLID AVE
CLEVELAND OH
44106-4901
US

IV. Provider business mailing address

8263 MULBERRY RD
CHESTERLAND OH
44026-1431
US

V. Phone/Fax

Practice location:
  • Phone: 440-474-2646
  • Fax:
Mailing address:
  • Phone: 440-474-2646
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03135775
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: