Healthcare Provider Details

I. General information

NPI: 1346674900
Provider Name (Legal Business Name): ASIA PLAZA PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 03/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2999 PAYNE AVE STE 130
CLEVELAND OH
44114-4436
US

IV. Provider business mailing address

2999 PAYNE AVE STE 130
CLEVELAND OH
44114-4436
US

V. Phone/Fax

Practice location:
  • Phone: 216-862-9688
  • Fax: 216-938-5436
Mailing address:
  • Phone: 216-862-9688
  • Fax: 216-938-5436

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number022300950
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: HUI WANG
Title or Position: OWNER
Credential: RPH
Phone: 216-862-9688