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NPI Code Detail

MEDICARE: MARY BOLAND

MEDICARE: MARY BOLAND
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacist03443865OH

General Provider Information

NPI Number : 1023960135
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY BOLAND
Provider Business Mailing Address
First Line : 3539 TUTTLE AVE
Second Line :
City : CLEVELAND
State : OH
Zip : 44111-3030
Country : US
Telephone Number : 216-767-3363
Fax Number :
Provider Business Practice Location Address
First Line : 10701 EAST BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1702
Country : US
Telephone Number : 216-791-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2026
Last Update Date : 02/11/2026

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Directions to “ MARY BOLAND ” Practice Location

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