Provider Demographics
NPI:1245425875
Name:NEWTON FALLS PHARMACY INC
Entity Type:Organization
Organization Name:NEWTON FALLS PHARMACY INC
Other - Org Name:NEWTON FALLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:YOCUM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:330-326-3851
Mailing Address - Street 1:37 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWTON FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44444-1232
Mailing Address - Country:US
Mailing Address - Phone:330-872-6400
Mailing Address - Fax:330-872-6401
Practice Address - Street 1:37 RIDGE RD
Practice Address - Street 2:
Practice Address - City:NEWTON FALLS
Practice Address - State:OH
Practice Address - Zip Code:44444-1232
Practice Address - Country:US
Practice Address - Phone:330-872-6400
Practice Address - Fax:330-872-6401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2011-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0217493503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3676357OtherNCPDP PROVIDER IDENTIFICATION NUMBER