MEDICARE: LORAIN CHEMISTS 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1528686763
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LORAIN CHEMISTS INC.

Provider Business Mailing Address
First Line	:	3815 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3710
Country	:	US
Telephone Number	:	216-860-0687
Fax Number	:

Provider Business Practice Location Address
First Line	:	3815 LORAIN AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44113-3710
Country	:	US
Telephone Number	:	216-860-0023
Fax Number	:	216-860-0687

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ERIC GOLDBERG
Credential	:
Telephone Number	:	844-985-0068

Provider Enumeration Date	:	07/13/2020
Last Update Date	:	02/14/2022

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