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General NPI Number Information
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NPI Number | 1700109345
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Entity Type | Organization
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Legal Business Name | MDCS, MEDICATION AND DISEASE CONSULTING SERVICES
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Dates
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Enumeration Date | 03/10/2010
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Last Update Date | 03/10/2010
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Provider Practice Location Address
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Address Line | 8635 MAYFIELD RD OFC 11A
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City | CHESTERLAND
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State | OH
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Zip | 44026-2659
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Country | US
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Telephone | 440-632-0284
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Fax | 440-632-0133
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Provider Business Mailing Address
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Address Line | 8635 MAYFIELD RD OFC 11A
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City | CHESTERLAND
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State | OH
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Zip | 44026-2659
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Country | US
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Telephone | 440-632-0284
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Fax | 440-632-0133
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Authorized Official
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Title or Position | OWNER
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Name | MR. RON WITLICKI
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Credential | RPH
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Telephone | 440-632-0284
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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 | CPO022029350
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License Number State | OH
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