MEDICARE: KLEINS PHARMACY & ORTHOPEDIC APPLIANCES INC AND SUBSIDIARY

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	3336C0004X	Compounding Pharmacy	02-0090600	OH
2	3336C0003X	Community/Retail Pharmacy	02-0090600	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659471654
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLEINS PHARMACY & ORTHOPEDIC APPLIANCES INC AND SUBSIDIARY

Provider Business Mailing Address
First Line	:	2015 STATE RD
Second Line	:	SUITE A
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-1425
Country	:	US
Telephone Number	:	330-928-3720
Fax Number	:	330-940-4241

Provider Business Practice Location Address
First Line	:	2015 STATE RD
Second Line	:	SUITE A
City	:	CUYAHOGA FALLS
State	:	OH
Zip	:	44223-1425
Country	:	US
Telephone Number	:	330-928-3720
Fax Number	:	330-940-4241

Authorized Official
Title or Position	:	PRESIDENT
Name	:	BARRY EDWARD KLEIN
Credential	:	MS, RPH
Telephone Number	:	330-928-3720

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	10/15/2012

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