Provider Demographics
NPI:1457495004
Name:PZB, LLC
Entity Type:Organization
Organization Name:PZB, LLC
Other - Org Name:SAINT CLAIR DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PERSE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:216-363-7402
Mailing Address - Street 1:6718 SAINT CLAIR AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44103-1744
Mailing Address - Country:US
Mailing Address - Phone:216-361-4212
Mailing Address - Fax:216-361-9890
Practice Address - Street 1:6718 SAINT CLAIR AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44103-1744
Practice Address - Country:US
Practice Address - Phone:216-361-4212
Practice Address - Fax:216-361-9890
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2016-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
OHRTP.022373500-033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0491383Medicaid
2145736OtherPK
OH0491383Medicaid