MEDICARE: CHRISTOPHER MARCUM PHARM D

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	03325738	OH

General Provider Information

NPI Number	:	1639486855
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER MARCUM PHARM D

Provider Business Mailing Address
First Line	:	12000 MCCRACKEN RD STE 151
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2962
Country	:	US
Telephone Number	:	216-587-8822
Fax Number	:

Provider Business Practice Location Address
First Line	:	12000 MCCRACKEN RD STE 151
Second Line	:
City	:	GARFIELD HEIGHTS
State	:	OH
Zip	:	44125-2962
Country	:	US
Telephone Number	:	216-587-8822
Fax Number	:

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

Provider Enumeration Date	:	09/09/2010
Last Update Date	:	09/09/2010

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