MEDICARE: RACHAEL IALACCI

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	1835P2201X	Ambulatory Care Pharmacist	03443872	OH

General Provider Information

NPI Number	:	1861326423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHAEL IALACCI

Provider Business Mailing Address
First Line	:	15803 VALLEYVIEW AVE
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44135-4305
Country	:	US
Telephone Number	:	216-406-1193
Fax Number	:

Provider Business Practice Location Address
First Line	:	5901 E ROYALTON RD STE 1100
Second Line	:
City	:	BROADVIEW HEIGHTS
State	:	OH
Zip	:	44147-3532
Country	:	US
Telephone Number	:	440-743-4740
Fax Number	:

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

Provider Enumeration Date	:	06/10/2026
Last Update Date	:	06/10/2026

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