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General NPI Number Information
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NPI Number | 1538438130
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Entity Type | Organization
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Legal Business Name | MT PLEASANT PHARMACY LLC
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Dates
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Enumeration Date | 12/28/2011
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Last Update Date | 03/09/2012
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Provider Practice Location Address
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Address Line | 12395 MCCRACKEN RD STE G
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-2946
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Country | US
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Telephone | 216-672-4377
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Fax | 216-475-4200
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Provider Business Mailing Address
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Address Line | 12395 MCCRACKEN RD STE G
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City | GARFIELD HEIGHTS
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State | OH
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Zip | 44125-2967
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Country | US
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Telephone | 216-672-4377
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Fax | 216-475-4200
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Authorized Official
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Title or Position | OWNER/RESPONSIBLE PHARMACIST
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Name | MICHAEL ASIEDU-GYEKYE
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Credential |
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Telephone | 216-200-2488
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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 | RTP022169850
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License Number State | OH
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