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NPI Code Detail

MEDICARE: CHRISTOPHER WEAVER

MEDICARE: CHRISTOPHER WEAVER
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
1183500000XPharmacist03331038OH

General Provider Information

NPI Number : 1902175607
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTOPHER WEAVER
Provider Business Mailing Address
First Line : 2472 W 7TH ST
Second Line :
City : CLEVELAND
State : OH
Zip : 44113-4548
Country : US
Telephone Number : 502-297-1396
Fax Number : 216-261-5138
Provider Business Practice Location Address
First Line : 22401 LAKE SHORE BLVD
Second Line :
City : EUCLID
State : OH
Zip : 44123-1312
Country : US
Telephone Number : 216-261-4497
Fax Number : 216-261-5138
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2011
Last Update Date : 12/26/2011

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Directions to “ CHRISTOPHER WEAVER ” Practice Location

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