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General NPI Number Information
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NPI Number | 1912638701
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Entity Type | Individual
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Provider Name | NICHOLAS PANDELARAS PHARMD
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Gender | Male
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Dates
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Enumeration Date | 06/22/2022
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Last Update Date | 06/22/2022
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Provider Practice Location Address
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Address Line | 900 WOOSTER RD N
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City | BARBERTON
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State | OH
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Zip | 44203-1659
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Country | US
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Telephone | 330-745-2674
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Fax |
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Provider Business Mailing Address
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Address Line | 806 DERBY AVE
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City | CAMP HILL
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State | PA
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Zip | 17011-8366
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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 | 03441849
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License Number State | OH
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