Healthcare Provider Details

I. General information

NPI: 1467446971
Provider Name (Legal Business Name): GLENN R RECH R.PH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2351 E 22ND ST
CLEVELAND OH
44115-3111
US

IV. Provider business mailing address

929 KING GEORGE BLVD
SOUTH EUCLID OH
44121-3407
US

V. Phone/Fax

Practice location:
  • Phone: 216-861-6200
  • Fax:
Mailing address:
  • Phone: 216-410-1613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number03113538
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: