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General NPI Number Information
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NPI Number | 1558761783
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Entity Type | Individual
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Provider Name | ELIZABETH MARY DAHL PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 9500 EUCLID AVE DEPARTMENT OF PHARMACY JJN1-200
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City | CLEVELAND
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State | OH
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Zip | 44195-0001
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Country | US
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Telephone | 216-442-5545
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Fax |
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Provider Business Mailing Address
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Address Line | 19601 VAN AKEN BLVD APT X2
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City | SHAKER HEIGHTS
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State | OH
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Zip | 44122-3573
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03234154
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License Number State | OH
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