Provider Demographics
NPI:1417279878
Name:PHARMACY COUNTER LLC
Entity Type:Organization
Organization Name:PHARMACY COUNTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GLADEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-824-7427
Mailing Address - Street 1:2142 N COVE BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3895
Mailing Address - Country:US
Mailing Address - Phone:419-824-7593
Mailing Address - Fax:419-824-3460
Practice Address - Street 1:2142 N COVE BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3895
Practice Address - Country:US
Practice Address - Phone:419-824-7593
Practice Address - Fax:419-824-3460
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PROMEDICA CONTINUING CARE SERVICES INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-25
Last Update Date:2010-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies