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General NPI Number Information
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NPI Number | 1871596460
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Entity Type | Organization
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Legal Business Name | PMC OHIO, LLC
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Dates
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Enumeration Date | 05/27/2005
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Last Update Date | 08/16/2018
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Provider Practice Location Address
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Address Line | 24165 DETROIT ROAD
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City | WESTLAKE
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State | OH
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Zip | 44145
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Country | US
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Telephone | 440-617-7646
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Fax | 440-617-1815
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Provider Business Mailing Address
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Address Line | 3802 CORPOREX PARK DR STE 150
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City | TAMPA
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State | FL
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Zip | 33619-1135
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Country | US
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Telephone | 813-318-6039
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT & SECRETARY
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Name | MR. THOMAS A CANERIS
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Credential |
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Telephone | 502-627-7000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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