MEDICARE: CELINE MARIE RAIBLE 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	183500000X	Pharmacist	03438983	OH

General Provider Information

NPI Number	:	1659976421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELINE MARIE RAIBLE PHARMD

Provider Business Mailing Address
First Line	:	2584 HOMEWOOD DR
Second Line	:
City	:	LORAIN
State	:	OH
Zip	:	44055-2850
Country	:	US
Telephone Number	:	440-522-1029
Fax Number	:

Provider Business Practice Location Address
First Line	:	27120 BAGLEY RD
Second Line	:
City	:	OLMSTED TWP
State	:	OH
Zip	:	44138-1062
Country	:	US
Telephone Number	:	440-235-1600
Fax Number	:

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

Provider Enumeration Date	:	12/01/2020
Last Update Date	:	12/01/2020

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Directions to “ CELINE MARIE RAIBLE PHARMD” Practice Location

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