Healthcare Provider Details

I. General information

NPI: 1417812884
Provider Name (Legal Business Name): CASEY O EWEROKE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7412 STATE RD
CLEVELAND OH
44134-4963
US

IV. Provider business mailing address

5500 SANDY HOOK DR
PARMA OH
44134-6126
US

V. Phone/Fax

Practice location:
  • Phone: 440-887-8038
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446229
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: