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NPI Code Detail

MEDICARE: MR. TODD MICHAEL DONNELLY R.PH., MS, MBA

MEDICARE: MR. TODD MICHAEL DONNELLY R.PH., MS, MBA
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
1183500000XPharmacist03-1-20684OH

General Provider Information

NPI Number : 1124001813
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TODD MICHAEL DONNELLY R.PH., MS, MBA
Provider Business Mailing Address
First Line : 13370 WALNUT TRCE
Second Line :
City : CHARDON
State : OH
Zip : 44024-9350
Country : US
Telephone Number : 440-554-5004
Fax Number :
Provider Business Practice Location Address
First Line : 8333 ROCKSIDE RD
Second Line :
City : CLEVELAND
State : OH
Zip : 44125-6134
Country : US
Telephone Number : 440-554-5004
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 11/12/2024

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