MEDICARE: DRAKE HAMBLETON

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	03443353	OH

General Provider Information

NPI Number	:	1316759772
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DRAKE HAMBLETON

Provider Business Mailing Address
First Line	:	7301 LAKE SHORE BLVD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-3029
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7301 LAKE SHORE BLVD
Second Line	:
City	:	MENTOR
State	:	OH
Zip	:	44060-3029
Country	:	US
Telephone Number	:	440-602-6071
Fax Number	:

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

Provider Enumeration Date	:	01/23/2025
Last Update Date	:	01/23/2025

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Directions to “ DRAKE HAMBLETON ” Practice Location

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