Healthcare Provider Details

I. General information

NPI: 1255927398
Provider Name (Legal Business Name): MILENA MRDJENOVIC PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/14/2020
Last Update Date: 02/02/2024
Certification Date: 02/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 COLLINGWOOD BLVD
TOLEDO OH
43620-1147
US

IV. Provider business mailing address

329 N WEST ST
LIMA OH
45801-4332
US

V. Phone/Fax

Practice location:
  • Phone: 567-318-3891
  • Fax: 419-225-8878
Mailing address:
  • Phone: 419-221-3072
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03438705
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: