Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Jul 12, 2023
License(s)
03443045 (OH)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 16207 DETROIT AVE | Lakewood, OH 44107-3784 | 216-521-8826 |
| MAILING | 14012 CLIFTON BLVD | Lakewood, OH 44107-2608 | 440-305-3086 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.