Healthcare Provider Details

I. General information

NPI: 1831226679
Provider Name (Legal Business Name): OHLIGER DRUG OF FAIRVIEW PARK INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 12/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21720 LORAIN RD
FAIRVIEW PARK OH
44126-3329
US

IV. Provider business mailing address

21720 LORAIN RD
FAIRVIEW PARK OH
44126-3329
US

V. Phone/Fax

Practice location:
  • Phone: 440-333-1200
  • Fax: 440-333-1207
Mailing address:
  • Phone: 440-333-1200
  • Fax: 440-333-1207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020125250
License Number StateOH

VIII. Authorized Official

Name: THOMAS OHLIGER
Title or Position: OWNER AND PHARMACIST
Credential: RPH
Phone: 440-333-1200