Healthcare Provider Details

I. General information

NPI: 1114900636
Provider Name (Legal Business Name): MEGAN RENAE HEMINGER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1745 FULTON RD
CLEVELAND OH
44113-3056
US

IV. Provider business mailing address

1745 FULTON RD
CLEVELAND OH
44113-3056
US

V. Phone/Fax

Practice location:
  • Phone: 216-621-1330
  • Fax:
Mailing address:
  • Phone: 216-621-1330
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03225228
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: