Healthcare Provider Details

I. General information

NPI: 1659556744
Provider Name (Legal Business Name): KEVIN FUSCHETTO PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2008
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4211 STATE ROUTE 44 STE 208-209
ROOTSTOWN OH
44272-9733
US

IV. Provider business mailing address

4211 STATE ROUTE 44 STE 208-209
ROOTSTOWN OH
44272-9733
US

V. Phone/Fax

Practice location:
  • Phone: 330-718-3178
  • Fax:
Mailing address:
  • Phone: 330-596-7970
  • Fax: 330-596-6624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03-2-27909
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03227909
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: