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General NPI Number Information
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NPI Number | 1033416854
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Entity Type | Organization
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Legal Business Name | SKILLED CARE DIRECT LLC
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Dates
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Enumeration Date | 02/14/2011
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 6175 HI TEK CT
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City | MASON
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State | OH
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Zip | 45040-2603
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Country | US
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Telephone | 513-492-5421
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Fax | 513-229-0600
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Provider Business Mailing Address
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Address Line | 6175 HI TEK CT
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City | MASON
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State | OH
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Zip | 45040-2603
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Country | US
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Telephone | 513-492-5421
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Fax | 513-229-0600
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Authorized Official
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Title or Position | PRESIDENT
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Name | LARRY GALLUZZO
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Credential |
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Telephone | 513-459-7455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RTP.022084300-03
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License Number State | OH
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