MEDICARE: DR. JEFFREY PAUL POPLOSKI PHARMD, LPC

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	03125741	OH
2	390200000X	Student in an Organized Health Care Education/Training Program
3	101YA0400X	Addiction (Substance Use Disorder) Counselor	C.2002503	OH

General Provider Information

NPI Number	:	1710267299
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY PAUL POPLOSKI PHARMD, LPC

Provider Business Mailing Address
First Line	:	4918 YORKSHIRE AVE
Second Line	:
City	:	PARMA
State	:	OH
Zip	:	44134-3728
Country	:	US
Telephone Number	:	412-400-9138
Fax Number	:

Provider Business Practice Location Address
First Line	:	20800 CENTER RIDGE RD STE 410
Second Line	:
City	:	ROCKY RIVER
State	:	OH
Zip	:	44116-4306
Country	:	US
Telephone Number	:	440-356-7620
Fax Number	:	440-356-7623

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

Provider Enumeration Date	:	08/28/2011
Last Update Date	:	07/26/2021

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