MEDICARE: JASKARAN SANDHU

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
1	183500000X	Pharmacist	03223067	OH

General Provider Information

NPI Number	:	1134891625
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JASKARAN SANDHU

Provider Business Mailing Address
First Line	:	15325 EDGECLIFF AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-2021
Country	:	US
Telephone Number	:	216-671-6550
Fax Number	:	216-671-6553

Provider Business Practice Location Address
First Line	:	15325 EDGECLIFF AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44111-2021
Country	:	US
Telephone Number	:	216-671-6550
Fax Number	:	216-671-6553

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/02/2021
Last Update Date	:	10/02/2021

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Directions to “ JASKARAN SANDHU ” Practice Location

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