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NPI Code Detail

MEDICARE: CASSANDRA LEE REGAL RPH

MEDICARE: CASSANDRA LEE REGAL RPH
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
1183500000XPharmacist03233696OH

General Provider Information

NPI Number : 1043810401
Entity Type Code : Individual
Provider Name (Legal Business Name) : CASSANDRA LEE REGAL RPH
Provider Business Mailing Address
First Line : 35901 CHESTER RD
Second Line :
City : AVON
State : OH
Zip : 44011-1069
Country : US
Telephone Number : 440-937-4760
Fax Number : 440-937-4762
Provider Business Practice Location Address
First Line : 35901 CHESTER RD
Second Line :
City : AVON
State : OH
Zip : 44011-1069
Country : US
Telephone Number : 440-937-4760
Fax Number : 440-937-4762
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2020
Last Update Date : 10/27/2020

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Directions to “ CASSANDRA LEE REGAL RPH” Practice Location

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