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General NPI Number Information
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NPI Number | 1992179154
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Entity Type | Organization
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Legal Business Name | UNIVERSITY HOSPITALS ST. JOHN MEDICAL CENTER
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Dates
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Enumeration Date | 11/25/2015
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Last Update Date | 04/29/2024
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Provider Practice Location Address
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Address Line | 29000 CENTER RIDGE RD PHARMACY DEPARTMENT
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City | WESTLAKE
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State | OH
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Zip | 44145-5219
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Country | US
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Telephone | 440-827-5040
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Fax | 440-827-5472
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Provider Business Mailing Address
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Address Line | PO BOX 772930
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City | DETROIT
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State | MI
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Zip | 48277-2930
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Country | US
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Telephone | 440-827-5040
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Fax | 440-827-5472
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Authorized Official
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Title or Position | DIRECTOR, FP&A
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Name | ANTHONY SCHILLERO
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Credential |
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Telephone | 216-767-8141
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | RTP.022594600-03
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License Number State | OH
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