Provider Demographics
NPI:1265857502
Name:PHARMACY COUNTER, LLC
Entity Type:Organization
Organization Name:PHARMACY COUNTER, LLC
Other - Org Name:PROMEDICA PHARMACY COUNTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CMO, PRESIDENT PPCS
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMERLING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:419-469-3842
Mailing Address - Street 1:5755 MONCLOVA RD
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1837
Mailing Address - Country:US
Mailing Address - Phone:419-893-2633
Mailing Address - Fax:
Practice Address - Street 1:5755 MONCLOVA RD
Practice Address - Street 2:
Practice Address - City:MAUMEE
Practice Address - State:OH
Practice Address - Zip Code:43537-1837
Practice Address - Country:US
Practice Address - Phone:419-893-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMEDICA COUNTINUING CARE SERVICES CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-24
Last Update Date:2014-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies