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NPI Code Detail

MEDICARE: CODY ERIC SIEBENALLER PHARMD

MEDICARE: CODY ERIC SIEBENALLER 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
1183500000XPharmacist03232853-2OH

General Provider Information

NPI Number : 1629419791
Entity Type Code : Individual
Provider Name (Legal Business Name) : CODY ERIC SIEBENALLER PHARMD
Provider Business Mailing Address
First Line : 27681 CAROLINE CIR
Second Line : UNIT H
City : WESTLAKE
State : OH
Zip : 44145-1165
Country : US
Telephone Number : 419-937-3592
Fax Number :
Provider Business Practice Location Address
First Line : 15149 SNOW RD
Second Line :
City : BROOKPARK
State : OH
Zip : 44142-2458
Country : US
Telephone Number : 216-676-5561
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/17/2013
Last Update Date : 07/17/2013

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Directions to “ CODY ERIC SIEBENALLER PHARMD” Practice Location

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