Healthcare Provider Details

I. General information

NPI: 1518993864
Provider Name (Legal Business Name): DISCOUNT DRUG MART INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 03/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

814 N MAIN ST
WELLINGTON OH
44090-1000
US

IV. Provider business mailing address

211 COMMERCE DR
MEDINA OH
44256-1331
US

V. Phone/Fax

Practice location:
  • Phone: 440-647-6634
  • Fax: 440-647-3436
Mailing address:
  • Phone: 330-725-2340
  • Fax: 330-764-4857

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number020422350
License Number StateOH

VIII. Authorized Official

Name: LAURA TAYLOR
Title or Position: PHARMACY COORDINATOR
Credential: CPHT
Phone: 330-725-2340