Healthcare Provider Details

I. General information

NPI: 1366543548
Provider Name (Legal Business Name): PAUL R BANDFIELD PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/23/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12301 SNOW RD
PARMA OH
44130-1002
US

IV. Provider business mailing address

6320 GREENWOOD PKWY APT 405
SAGAMORE HILLS OH
44067-2352
US

V. Phone/Fax

Practice location:
  • Phone: 216-265-4406
  • Fax: 216-265-4483
Mailing address:
  • Phone: 330-908-2922
  • Fax: 216-265-4483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-3-26780
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: