MEDICARE: MR. DAVID LOUIS ISAACS RPH CDM

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	03-1-10770	OH

General Provider Information

NPI Number	:	1639172398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID LOUIS ISAACS RPH CDM

Provider Business Mailing Address
First Line	:	1929 CAMBERLY DR
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-3733
Country	:	US
Telephone Number	:	440-461-5484
Fax Number	:	216-297-2003

Provider Business Practice Location Address
First Line	:	1929 CAMBERLY DR
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-3733
Country	:	US
Telephone Number	:	440-461-5484
Fax Number	:	216-297-2003

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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