Healthcare Provider Details

I. General information

NPI: 1356379440
Provider Name (Legal Business Name): DISCOUNT DRUG MART INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1695 N MAIN ST
NORTH CANTON OH
44720-8605
US

IV. Provider business mailing address

211 COMMERCE DR
MEDINA OH
44256-1331
US

V. Phone/Fax

Practice location:
  • Phone: 330-497-9393
  • Fax: 330-497-6525
Mailing address:
  • Phone: 330-725-2340
  • Fax: 330-764-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020780550
License Number StateOH

VIII. Authorized Official

Name: LAURA TAYLOR
Title or Position: PHARMACY COORDINATOR
Credential: CPHT
Phone: 330-725-2340