MEDICARE: MARISSA DUCO 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	1835X0200X	Oncology Pharmacist	03441896	OH
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03441896	OH

General Provider Information

NPI Number	:	1578291571
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARISSA DUCO PHARMD

Provider Business Mailing Address
First Line	:	3651 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7752
Country	:	US
Telephone Number	:	614-282-5510
Fax Number	:

Provider Business Practice Location Address
First Line	:	3651 RIDGE MILL DR
Second Line	:
City	:	HILLIARD
State	:	OH
Zip	:	43026-7752
Country	:	US
Telephone Number	:	614-282-5510
Fax Number	:

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

Provider Enumeration Date	:	08/09/2022
Last Update Date	:	04/15/2026

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