Healthcare Provider Details

I. General information

NPI: 1437324522
Provider Name (Legal Business Name): SKILLED CARE PHARMACY,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2008
Last Update Date: 05/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6175 HI TEK CT
MASON OH
45040-2603
US

IV. Provider business mailing address

6175 HI TEK COURT
MASON OH
45040
US

V. Phone/Fax

Practice location:
  • Phone: 513-459-7455
  • Fax: 800-786-9419
Mailing address:
  • Phone: 513-459-7455
  • Fax: 800-786-9419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number022280050
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number022280050
License Number StateOH

VIII. Authorized Official

Name: MR. FRANCIS LAWRENCE GALLUZZO
Title or Position: PRESIDENT
Credential: R.PH
Phone: 513-459-7455