Provider Demographics
NPI:1164883294
Name:ACCUDOSE PHARMACY
Entity Type:Organization
Organization Name:ACCUDOSE PHARMACY
Other - Org Name:ACCUDOSE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCESCHELLI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-915-5632
Mailing Address - Street 1:3728 BRAEMAR DR
Mailing Address - Street 2:
Mailing Address - City:RICHFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44286-9035
Mailing Address - Country:US
Mailing Address - Phone:888-222-6185
Mailing Address - Fax:
Practice Address - Street 1:685 BOARDMAN CANFIELD RD STE 3
Practice Address - Street 2:
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-4711
Practice Address - Country:US
Practice Address - Phone:888-222-6185
Practice Address - Fax:888-222-3045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-17
Last Update Date:2017-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OHPMY.022582250-033336L0003X
OHMOP.022582250-0333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0165019Medicaid
2158792OtherPK