MEDICARE: WEST AKRON ENTERPRISES INC

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	333600000X	Pharmacy
2	3336C0004X	Compounding Pharmacy
3	3336C0003X	Community/Retail Pharmacy	RTP.020603400-03	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2071400	OTHER		PK

General Provider Information

NPI Number	:	1528170537
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WEST AKRON ENTERPRISES INC

Provider Business Mailing Address
First Line	:	40 SAND RUN RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-6200
Country	:	US
Telephone Number	:	330-864-2138
Fax Number	:	330-864-9457

Provider Business Practice Location Address
First Line	:	40 SAND RUN RD
Second Line	:
City	:	AKRON
State	:	OH
Zip	:	44313-6200
Country	:	US
Telephone Number	:	330-864-2138
Fax Number	:	330-864-9457

Authorized Official
Title or Position	:	OWNER,PIC,AO
Name	:	THOMAS LAMB
Credential	:	RPH
Telephone Number	:	330-864-2138

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	05/16/2016

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1588829212 — DR. RICHARD M. HOFACKER, INC.
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1790561835 — KATIE CUNNINGHAM, D.D.S., LLC
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1417749011 — AUREA CRANIAL PROSTHETICS L.L.C.
Practice Location Address:

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Directions to “WEST AKRON ENTERPRISES INC ” Practice Location

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