Healthcare Provider Details

I. General information

NPI: 1255602314
Provider Name (Legal Business Name): ROMANA ANDREA KUCHTA PHARMD, RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2012
Last Update Date: 01/21/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22401 LAKE SHORE BLVD
EUCLID OH
44123-1312
US

IV. Provider business mailing address

9144 E WASHINGTON ST
CHAGRIN FALLS OH
44023-2745
US

V. Phone/Fax

Practice location:
  • Phone: 216-261-4497
  • Fax: 216-261-5138
Mailing address:
  • Phone: 440-668-8265
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03328998
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: