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General NPI Number Information
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NPI Number | 1821695594
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Entity Type | Organization
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Legal Business Name | SIGNATURE HEALTH INC. PHARMACY
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Dates
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Enumeration Date | 10/06/2020
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 53 S SAINT CLAIR ST
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City | PAINESVILLE
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State | OH
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Zip | 44077-3418
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Country | US
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Telephone | 440-853-1225
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Fax | 440-853-1134
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Provider Business Mailing Address
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Address Line | 53 S SAINT CLAIR ST
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City | PAINESVILLE
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State | OH
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Zip | 44077-3418
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Country | US
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Telephone | 440-578-8200
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Fax |
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Authorized Official
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Title or Position | CHIEF PHARMACY OFFICER
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Name | KELLEY S DRAGAR
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Credential |
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Telephone | 440-578-8200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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