Provider Demographics
NPI:1609246081
Name:PARAM SANTOSH LLC
Entity Type:Organization
Organization Name:PARAM SANTOSH LLC
Other - Org Name:TONY'S PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHETAN
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-651-5700
Mailing Address - Street 1:3114 CLARK AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44109-1146
Mailing Address - Country:US
Mailing Address - Phone:216-651-5700
Mailing Address - Fax:216-744-2594
Practice Address - Street 1:3114 CLARK AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44109-1146
Practice Address - Country:US
Practice Address - Phone:216-651-5700
Practice Address - Fax:216-744-2594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-29
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH02-25493503336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy