MEDICARE: FARAH JOY GRANDALSKI PHARMD

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	03132310	OH

General Provider Information

NPI Number	:	1508115650
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FARAH JOY GRANDALSKI PHARMD

Provider Business Mailing Address
First Line	:	2419 SAYBROOK RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3701
Country	:	US
Telephone Number	:	814-860-4126
Fax Number	:

Provider Business Practice Location Address
First Line	:	2419 SAYBROOK RD
Second Line	:
City	:	UNIVERSITY HEIGHTS
State	:	OH
Zip	:	44118-3701
Country	:	US
Telephone Number	:	814-860-4126
Fax Number	:

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

Provider Enumeration Date	:	09/05/2012
Last Update Date	:	09/05/2012

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