MEDICARE: RAYMOND EDWARD GALUZNY 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	03310472	OH

General Provider Information

NPI Number	:	1861098022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RAYMOND EDWARD GALUZNY RPH

Provider Business Mailing Address
First Line	:	1448 BROOKPARK DR
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44906-3504
Country	:	US
Telephone Number	:	419-571-9433
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 LEXINGTON AVE
Second Line	:
City	:	MANSFIELD
State	:	OH
Zip	:	44907-2629
Country	:	US
Telephone Number	:	419-756-1321
Fax Number	:	419-756-6632

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

Provider Enumeration Date	:	12/11/2020
Last Update Date	:	12/11/2020

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