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NPI Code Detail

MEDICARE: NICHOLAS BETKA PHARMACIST

MEDICARE:   NICHOLAS  BETKA  PHARMACIST
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
1183500000XPharmacist03236945OH

General Provider Information

NPI Number : 1881298503
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS BETKA PHARMACIST
Provider Business Mailing 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 :
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 : 11/23/2020
Last Update Date : 11/23/2020

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Directions to “ NICHOLAS BETKA PHARMACIST” Practice Location

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