Provider Demographics
NPI:1548384050
Name:REHABILITATION HOSPITAL AT HEATHER HILL PHARMACY
Entity Type:Organization
Organization Name:REHABILITATION HOSPITAL AT HEATHER HILL PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:MIKE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGRATH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:440-279-2412
Mailing Address - Street 1:12340 BASS LAKE RD
Mailing Address - Street 2:PHARMACY DEPARTMENT
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-8327
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12340 BASS LAKE RD
Practice Address - Street 2:PHARMACY DEPARTMENT
Practice Address - City:CHARDON
Practice Address - State:OH
Practice Address - Zip Code:44024-8327
Practice Address - Country:US
Practice Address - Phone:440-279-2412
Practice Address - Fax:440-279-2515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy