Provider Demographics
NPI:1326036039
Name:PHARMCO MANAGEMENT, LLC
Entity Type:Organization
Organization Name:PHARMCO MANAGEMENT, LLC
Other - Org Name:SCRIPTSHOP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROSARIO
Authorized Official - Middle Name:S
Authorized Official - Last Name:CARCIONE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:330-879-5626
Mailing Address - Street 1:4254 ERIE SW
Mailing Address - Street 2:
Mailing Address - City:NAVARRE
Mailing Address - State:OH
Mailing Address - Zip Code:44662
Mailing Address - Country:US
Mailing Address - Phone:330-879-5626
Mailing Address - Fax:330-879-5666
Practice Address - Street 1:4254 ERIE SW
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:OH
Practice Address - Zip Code:44662
Practice Address - Country:US
Practice Address - Phone:330-879-5626
Practice Address - Fax:330-879-5666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-07
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02141300332B00000X, 332BP3500X, 333600000X, 335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0457557Medicaid
3644691OtherNCPDP
OH5123230001Medicare ID - Type Unspecified