Provider Demographics
NPI:1033405113
Name:CENTRAL RX PHARMACY & MEDICAL SUPPLY LLC
Entity Type:Organization
Organization Name:CENTRAL RX PHARMACY & MEDICAL SUPPLY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:LEMMA
Authorized Official - Middle Name:M
Authorized Official - Last Name:GETACHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-621-7700
Mailing Address - Street 1:2475 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-3206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2475 E 22ND ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-3221
Practice Address - Country:US
Practice Address - Phone:216-621-7700
Practice Address - Fax:216-295-0146
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy