MEDICARE: QIAOYUAN DUAN RPH

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	03441147	OH

General Provider Information

NPI Number	:	1760196307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QIAOYUAN DUAN RPH

Provider Business Mailing Address
First Line	:	2805 MARIGOLD AVE
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43207-3543
Country	:	US
Telephone Number	:	216-536-1502
Fax Number	:

Provider Business Practice Location Address
First Line	:	6259 MAYFIELD RD
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44124-3217
Country	:	US
Telephone Number	:	440-449-3940
Fax Number	:

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

Provider Enumeration Date	:	01/09/2023
Last Update Date	:	01/09/2023

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Directions to “ QIAOYUAN DUAN RPH” Practice Location

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