Provider Demographics
NPI:1316021447
Name:OHLIGER DRUG OF NORTH OLMSTED INC
Entity Type:Organization
Organization Name:OHLIGER DRUG OF NORTH OLMSTED INC
Other - Org Name:OHLIGER DRUG OF NORTH OLMSTED
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MONICA
Authorized Official - Middle Name:
Authorized Official - Last Name:OHLIGER-LAVELLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:440-777-6200
Mailing Address - Street 1:27121 CENTER RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-4024
Mailing Address - Country:US
Mailing Address - Phone:440-777-6200
Mailing Address - Fax:440-734-7340
Practice Address - Street 1:27121 CENTER RIDGE RD
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-4024
Practice Address - Country:US
Practice Address - Phone:440-777-6200
Practice Address - Fax:440-734-7340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336L0003X
OH0201229003336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2072900OtherPK
OH0103293Medicaid
0485560001Medicare NSC