Healthcare Provider Details

I. General information

NPI: 1114095874
Provider Name (Legal Business Name): CONTINUUMCARE PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 02/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 CENTRAL AVE 1ST FLR
MIDDLETOWN OH
45044-4011
US

IV. Provider business mailing address

74 PERRY WINKLE LN
HUNTINGTON WV
25702-9506
US

V. Phone/Fax

Practice location:
  • Phone: 513-422-7705
  • Fax: 513-422-9238
Mailing address:
  • Phone: 304-736-4608
  • Fax: 304-736-2456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number021855400
License Number StateOH

VIII. Authorized Official

Name: THOMAS CANERIS
Title or Position: VICE PRESIDENT
Credential:
Phone: 502-627-7100