Provider Demographics
NPI:1356305585
Name:WEARSCH PHARMACY INC
Entity Type:Organization
Organization Name:WEARSCH PHARMACY INC
Other - Org Name:PHARMACY CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WEARSCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:330-286-0226
Mailing Address - Street 1:11 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-1318
Mailing Address - Country:US
Mailing Address - Phone:330-286-0226
Mailing Address - Fax:330-286-0269
Practice Address - Street 1:11 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-1318
Practice Address - Country:US
Practice Address - Phone:330-286-0226
Practice Address - Fax:330-286-0269
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-14
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
OH0221868503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
3659034OtherNCPDP PROVIDER IDENTIFICATION NUMBER
OH0947471Medicaid