Healthcare Provider Details

I. General information

NPI: 1356245856
Provider Name (Legal Business Name): CRAIG CUSANO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2250 LINDEN ST
LEWIS CENTER OH
43035-1548
US

IV. Provider business mailing address

2250 LINDEN ST
LEWIS CENTER OH
43035-1548
US

V. Phone/Fax

Practice location:
  • Phone: 330-719-1063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03135069
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: