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General NPI Number Information
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NPI Number | 1851100291
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Entity Type | Organization
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Legal Business Name | TAILOR MADE SEAMOSS LTD
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Dates
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Enumeration Date | 12/31/2024
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Last Update Date | 01/13/2025
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Provider Practice Location Address
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Address Line | 635 BROADWAY AVE
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City | BEDFORD
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State | OH
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Zip | 44146-3504
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Country | US
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Telephone | 216-889-7832
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Fax |
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Provider Business Mailing Address
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Address Line | 635 BROADWAY AVE
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City | BEDFORD
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State | OH
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Zip | 44146-3504
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Country | US
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Telephone | 216-889-7832
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MRS. DEAIRRA D TAYLOR
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Credential |
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Telephone | 216-527-3630
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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