Healthcare Provider Details

I. General information

NPI: 1972466811
Provider Name (Legal Business Name): EDWARD WILFRED OTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6871 AMES RD APT 511
PARMA OH
44129-5835
US

IV. Provider business mailing address

6871 AMES RD APT 511
PARMA OH
44129-5835
US

V. Phone/Fax

Practice location:
  • Phone: 216-972-4447
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03446260
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: