Healthcare Provider Details

I. General information

NPI: 1639172398
Provider Name (Legal Business Name): DAVID LOUIS ISAACS RPH CDM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1929 CAMBERLY DR
LYNDHURST OH
44124-3733
US

IV. Provider business mailing address

1929 CAMBERLY DR
LYNDHURST OH
44124-3733
US

V. Phone/Fax

Practice location:
  • Phone: 440-461-5484
  • Fax: 216-297-2003
Mailing address:
  • Phone: 440-461-5484
  • Fax: 216-297-2003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-1-10770
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: