MEDICARE: MR. JOHN LEROY HAMMOND JR. 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
1	183500000X	Pharmacist	03310049	OH

General Provider Information

NPI Number	:	1225633001
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN LEROY HAMMOND JR. RPH

Provider Business Mailing Address
First Line	:	358 YALE AVE
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-7112
Country	:	US
Telephone Number	:	440-323-1255
Fax Number	:	440-366-5494

Provider Business Practice Location Address
First Line	:	443 CLEVELAND ST
Second Line	:
City	:	ELYRIA
State	:	OH
Zip	:	44035-4062
Country	:	US
Telephone Number	:	440-365-7162
Fax Number	:	440-366-5494

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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