Healthcare Provider Details

I. General information

NPI: 1770716649
Provider Name (Legal Business Name): PHARMACY CONSULTANTS OF EAST-CENTRAL OHIO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2009
Last Update Date: 03/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9559 ROWE RD NW
SUGARCREEK OH
44681-6902
US

IV. Provider business mailing address

9559 ROWE RD NW
SUGARCREEK OH
44681-6902
US

V. Phone/Fax

Practice location:
  • Phone: 330-340-2885
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03221279
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number
License Number State

VIII. Authorized Official

Name: ERIC DURBIN
Title or Position: PRESIDENT
Credential: RPH
Phone: 330-340-2885